Follow‐up Compliance in Febrile Children: A Comparison of Two Systems

. Objectives:Follow‐up compliance is critical in febrile children because they may harbor unrecognized life‐threatening illnesses. This study compares follow‐up rates between 2 systems: Wilford Hall Medical Center (WHMC), with preset appointments after ED release, and free medical care; and Fairfax Hospital (FFX), where parents must arrange follow‐up appointments after ED release, and are responsible for payment for their follow‐up visits. The study also investigated factors associated with follow‐up compliance. Methods:This was a prospective, observational study of febrile children seen in 2 EDs with different systems for patient follow‐up. From ED records and parental phone calls, diagnosis, follow‐up compliance, and demographics were collected. Data were analyzed using logistic regression and χ2. Results:423 children met entrance criteria, and 330 parents were successfully contacted after the child's ED release (146 from WHMC; 184 from FFX). The WHMC children were more likely to comply with follow‐up than were the children in the FFX system (92% vs 67% follow‐up, odds ratio 2.5, 95% CI 1.1–5.3). Other factors associated with noncompliance with recommended follow‐up were: Hispanic ethnicity, non‐English‐speaking parents, and follow‐up suggested for