Improving Outpatient Follow-Up Rates for New In-Hospital Consults
This investigation aimed to define the rate of outpatient follow-up after in-hospital consultation, identify factors associated with establishing care, and evaluate an alternative scheduling process to improve outpatient adherence. Two-phase, prospective study at an academic, tertiary-care instituti...
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| Veröffentlicht in: | The Laryngoscope 2023-10, Vol.133 (10), p.2540-2545 |
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| container_title | The Laryngoscope |
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| creator | Stanisce, Luke Ahmad, Nadir Solomon, Donald H Kolia, Nadeem Garcia, Lucia D Spalla, Thomas C Gaughan, John P Koshkareva, Yekaterina |
| description | This investigation aimed to define the rate of outpatient follow-up after in-hospital consultation, identify factors associated with establishing care, and evaluate an alternative scheduling process to improve outpatient adherence.
Two-phase, prospective study at an academic, tertiary-care institution from March 2020 to August 2022. First, all patients not previously known to our practice encountered via inpatient consult who warranted outpatient follow-up were prospectively captured. Logistic regression analysis was used to identify demographic, disease, and practice factors predictive of follow-up. Second, a randomized control trial was performed to validate the effects of pre-assigning appointments prior to discharge.
Six hundred subjects were included in the final study cohort; 500 in phase-one, and 100 randomized during phase-two. In the phase-one cohort, 54% (n = 272) were lost to follow-up. Multivariate analysis showed increased odds of outpatient follow-up when appointments were pre-assigned before discharge (odds ratio [OR]: 3.69 [95% confidence interval [CI]: 2.29-5.96], p |
| doi_str_mv | 10.1002/lary.30519 |
| format | Article |
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Two-phase, prospective study at an academic, tertiary-care institution from March 2020 to August 2022. First, all patients not previously known to our practice encountered via inpatient consult who warranted outpatient follow-up were prospectively captured. Logistic regression analysis was used to identify demographic, disease, and practice factors predictive of follow-up. Second, a randomized control trial was performed to validate the effects of pre-assigning appointments prior to discharge.
Six hundred subjects were included in the final study cohort; 500 in phase-one, and 100 randomized during phase-two. In the phase-one cohort, 54% (n = 272) were lost to follow-up. Multivariate analysis showed increased odds of outpatient follow-up when appointments were pre-assigned before discharge (odds ratio [OR]: 3.69 [95% confidence interval [CI]: 2.29-5.96], p < 0.001), the primary reason for hospitalization was ENT and consult-related (OR: 3.29 [1.92-5.64], p < 0.001), and the diagnosis was one of Oncology (OR: 1.93 [1.02-3.69], p = 0.045) or Pediatrics (OR: 3.36 [1.41-7.98], p = 0.006) subspecialties. During phase-two, subjects randomized for pre-assigned appointments had higher outpatient follow-up (82%) compared to the control group (20%) (p < 0.001).
Hospital-based consultations represent an important referral pathway for new patients. Disease characteristics may identify patients less likely to follow-up upon discharge. Appointment scheduling protocols, including pre-assigning appointments, are modifiable targets for improving adherence to care. Laryngoscope, 2022.</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.30519</identifier><identifier>PMID: 36511340</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Laryngoscopy ; Otolaryngology ; Patient compliance</subject><ispartof>The Laryngoscope, 2023-10, Vol.133 (10), p.2540-2545</ispartof><rights>2022 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c274t-401e27a9e02b33bfdf2b019518bab6fe896ff956935e16ee5139313020df11d03</cites><orcidid>0000-0001-9681-6052</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36511340$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stanisce, Luke</creatorcontrib><creatorcontrib>Ahmad, Nadir</creatorcontrib><creatorcontrib>Solomon, Donald H</creatorcontrib><creatorcontrib>Kolia, Nadeem</creatorcontrib><creatorcontrib>Garcia, Lucia D</creatorcontrib><creatorcontrib>Spalla, Thomas C</creatorcontrib><creatorcontrib>Gaughan, John P</creatorcontrib><creatorcontrib>Koshkareva, Yekaterina</creatorcontrib><title>Improving Outpatient Follow-Up Rates for New In-Hospital Consults</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>This investigation aimed to define the rate of outpatient follow-up after in-hospital consultation, identify factors associated with establishing care, and evaluate an alternative scheduling process to improve outpatient adherence.
Two-phase, prospective study at an academic, tertiary-care institution from March 2020 to August 2022. First, all patients not previously known to our practice encountered via inpatient consult who warranted outpatient follow-up were prospectively captured. Logistic regression analysis was used to identify demographic, disease, and practice factors predictive of follow-up. Second, a randomized control trial was performed to validate the effects of pre-assigning appointments prior to discharge.
Six hundred subjects were included in the final study cohort; 500 in phase-one, and 100 randomized during phase-two. In the phase-one cohort, 54% (n = 272) were lost to follow-up. Multivariate analysis showed increased odds of outpatient follow-up when appointments were pre-assigned before discharge (odds ratio [OR]: 3.69 [95% confidence interval [CI]: 2.29-5.96], p < 0.001), the primary reason for hospitalization was ENT and consult-related (OR: 3.29 [1.92-5.64], p < 0.001), and the diagnosis was one of Oncology (OR: 1.93 [1.02-3.69], p = 0.045) or Pediatrics (OR: 3.36 [1.41-7.98], p = 0.006) subspecialties. During phase-two, subjects randomized for pre-assigned appointments had higher outpatient follow-up (82%) compared to the control group (20%) (p < 0.001).
Hospital-based consultations represent an important referral pathway for new patients. Disease characteristics may identify patients less likely to follow-up upon discharge. Appointment scheduling protocols, including pre-assigning appointments, are modifiable targets for improving adherence to care. Laryngoscope, 2022.</description><subject>Laryngoscopy</subject><subject>Otolaryngology</subject><subject>Patient compliance</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNpdkMFKw0AURQdRbK1u_AAJuBEh9b15mSSzLMXaQrEgFtyFSTMjKUkmZhKLf29qqwtXd3EPl8th7BphjAD8oVDN15hAoDxhQxSEfiClOGXDviQ_FvxtwC6c2wJgRALO2YBCgUgBDNlkUdaN_cyrd2_VtbVqc1213swWhd3569p7Ua12nrGN96x33qLy59bVeasKb2or1xWtu2RnRhVOXx1zxNazx9fp3F-unhbTydLf8Cho_QBQ80hJDTwlSk1meAooBcapSkOjYxkaI0UoSWgMtRZIkpCAQ2YQM6ARuzvs9n8_Ou3apMzdRheFqrTtXMIjEUAgifbo7T90a7um6t8lPA5DEEBc9NT9gdo01rlGm6Ru8rJ3mSAke7HJXmzyI7aHb46TXVrq7A_9NUnflXRxtQ</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Stanisce, Luke</creator><creator>Ahmad, Nadir</creator><creator>Solomon, Donald H</creator><creator>Kolia, Nadeem</creator><creator>Garcia, Lucia D</creator><creator>Spalla, Thomas C</creator><creator>Gaughan, John P</creator><creator>Koshkareva, Yekaterina</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9681-6052</orcidid></search><sort><creationdate>20231001</creationdate><title>Improving Outpatient Follow-Up Rates for New In-Hospital Consults</title><author>Stanisce, Luke ; Ahmad, Nadir ; Solomon, Donald H ; Kolia, Nadeem ; Garcia, Lucia D ; Spalla, Thomas C ; Gaughan, John P ; Koshkareva, Yekaterina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c274t-401e27a9e02b33bfdf2b019518bab6fe896ff956935e16ee5139313020df11d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Laryngoscopy</topic><topic>Otolaryngology</topic><topic>Patient compliance</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stanisce, Luke</creatorcontrib><creatorcontrib>Ahmad, Nadir</creatorcontrib><creatorcontrib>Solomon, Donald H</creatorcontrib><creatorcontrib>Kolia, Nadeem</creatorcontrib><creatorcontrib>Garcia, Lucia D</creatorcontrib><creatorcontrib>Spalla, Thomas C</creatorcontrib><creatorcontrib>Gaughan, John P</creatorcontrib><creatorcontrib>Koshkareva, Yekaterina</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stanisce, Luke</au><au>Ahmad, Nadir</au><au>Solomon, Donald H</au><au>Kolia, Nadeem</au><au>Garcia, Lucia D</au><au>Spalla, Thomas C</au><au>Gaughan, John P</au><au>Koshkareva, Yekaterina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improving Outpatient Follow-Up Rates for New In-Hospital Consults</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2023-10-01</date><risdate>2023</risdate><volume>133</volume><issue>10</issue><spage>2540</spage><epage>2545</epage><pages>2540-2545</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>This investigation aimed to define the rate of outpatient follow-up after in-hospital consultation, identify factors associated with establishing care, and evaluate an alternative scheduling process to improve outpatient adherence.
Two-phase, prospective study at an academic, tertiary-care institution from March 2020 to August 2022. First, all patients not previously known to our practice encountered via inpatient consult who warranted outpatient follow-up were prospectively captured. Logistic regression analysis was used to identify demographic, disease, and practice factors predictive of follow-up. Second, a randomized control trial was performed to validate the effects of pre-assigning appointments prior to discharge.
Six hundred subjects were included in the final study cohort; 500 in phase-one, and 100 randomized during phase-two. In the phase-one cohort, 54% (n = 272) were lost to follow-up. Multivariate analysis showed increased odds of outpatient follow-up when appointments were pre-assigned before discharge (odds ratio [OR]: 3.69 [95% confidence interval [CI]: 2.29-5.96], p < 0.001), the primary reason for hospitalization was ENT and consult-related (OR: 3.29 [1.92-5.64], p < 0.001), and the diagnosis was one of Oncology (OR: 1.93 [1.02-3.69], p = 0.045) or Pediatrics (OR: 3.36 [1.41-7.98], p = 0.006) subspecialties. During phase-two, subjects randomized for pre-assigned appointments had higher outpatient follow-up (82%) compared to the control group (20%) (p < 0.001).
Hospital-based consultations represent an important referral pathway for new patients. Disease characteristics may identify patients less likely to follow-up upon discharge. Appointment scheduling protocols, including pre-assigning appointments, are modifiable targets for improving adherence to care. Laryngoscope, 2022.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36511340</pmid><doi>10.1002/lary.30519</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-9681-6052</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Laryngoscopy Otolaryngology Patient compliance |
| title | Improving Outpatient Follow-Up Rates for New In-Hospital Consults |
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