Efficacy of the follow-up system in the community hospital emergency department.

Emergency department patients are believed to have high rates of noncompliance with instructions to obtain follow-up care. A study of emergency department patients at a medium-sized community hospital without clinics showed that compliance is better than rates previously published for hospital follow-up clinics. There was significantly less compliance by patients referred to an unknown on-call physician (59.4%) compared with patients referred to their own private physicians (83.7%) or back to the emergency department (73.2%). Compliance improved (79.2%), however, when the emergency physician discussed the case with the on-call physician and the patient was so informed. This phone call significantly increased the likelihood of compliance by one third. The phone call served as an introduction and a liaison between the patient and the on-call physician. The major reason for noncompliance with advised follow-up was that the patients "felt better" or didn't "feel it was necessary" (36%), rather than "expense" or "inability to get appointment in time" (8%).