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...
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| Veröffentlicht in: | Academic emergency medicine 1998-10, Vol.5 (10), p.996-1001 |
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| creator | Hemphill, Robin R. Santen, Sally A. Howell, John M. Altieri, Michael F. |
| description | . 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 |
| doi_str_mv | 10.1111/j.1553-2712.1998.tb02779.x |
| format | Article |
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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 <24 hours after ED release. For FFX, self‐pay, lack of a follow‐up physician, parents' dissatisfaction with the ED medical care, and diagnosis of otitis media were also significant factors found associated with noncompliance.
Conclusion:Febrile children evaluated in a medical system with prearranged follow‐up appointments and free medical care are more likely to comply with recommended follow‐up than are those evaluated in a system where payment and appointments are the responsibility of the parents. Efforts should be made to improve follow‐up compliance by modeling the WHMC system.</description><identifier>ISSN: 1069-6563</identifier><identifier>EISSN: 1553-2712</identifier><identifier>DOI: 10.1111/j.1553-2712.1998.tb02779.x</identifier><identifier>PMID: 9862592</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Child, Preschool ; Continuity of Patient Care ; Emergency Medical Services - standards ; emergency medicine ; Female ; fever ; Fever - therapy ; follow‐up studies ; Hospitals, Military ; Hospitals, Urban ; Humans ; Infant ; Insurance, Health ; Logistic Models ; Male ; Patient Compliance ; pediatrics ; Prospective Studies ; United States ; Virginia</subject><ispartof>Academic emergency medicine, 1998-10, Vol.5 (10), p.996-1001</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4226-ff0a869465da83f4eac92cd2cafa878732bc1f23dc71c477be5eb355a2f4b65a3</citedby><cites>FETCH-LOGICAL-c4226-ff0a869465da83f4eac92cd2cafa878732bc1f23dc71c477be5eb355a2f4b65a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1553-2712.1998.tb02779.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1553-2712.1998.tb02779.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,1432,27922,27923,45572,45573,46407,46831</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9862592$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hemphill, Robin R.</creatorcontrib><creatorcontrib>Santen, Sally A.</creatorcontrib><creatorcontrib>Howell, John M.</creatorcontrib><creatorcontrib>Altieri, Michael F.</creatorcontrib><title>Follow‐up Compliance in Febrile Children: A Comparison of Two Systems</title><title>Academic emergency medicine</title><addtitle>Acad Emerg Med</addtitle><description>. 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 <24 hours after ED release. For FFX, self‐pay, lack of a follow‐up physician, parents' dissatisfaction with the ED medical care, and diagnosis of otitis media were also significant factors found associated with noncompliance.
Conclusion:Febrile children evaluated in a medical system with prearranged follow‐up appointments and free medical care are more likely to comply with recommended follow‐up than are those evaluated in a system where payment and appointments are the responsibility of the parents. Efforts should be made to improve follow‐up compliance by modeling the WHMC system.</description><subject>Child, Preschool</subject><subject>Continuity of Patient Care</subject><subject>Emergency Medical Services - standards</subject><subject>emergency medicine</subject><subject>Female</subject><subject>fever</subject><subject>Fever - therapy</subject><subject>follow‐up studies</subject><subject>Hospitals, Military</subject><subject>Hospitals, Urban</subject><subject>Humans</subject><subject>Infant</subject><subject>Insurance, Health</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Patient Compliance</subject><subject>pediatrics</subject><subject>Prospective Studies</subject><subject>United States</subject><subject>Virginia</subject><issn>1069-6563</issn><issn>1553-2712</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkEFOwzAQRS0EKqVwBKSIBbsEx4ntuBtURW1BKmJBWVuOY4tUThziRm13HIEzchISGnXPbGak__-M5gFwF8Ig7OphE4QYRz6iIQpCxpJgm0FEKQv2Z2B8ks67GRLmE0yiS3Dl3AZCiCmjIzBiCUGYoTFYLqwxdvfz9d3WXmrL2hSiksorKm-hsqYwyks_CpM3qpp6sz-HaApnK89qb72z3tvBbVXprsGFFsapm6FPwPtivk6f_NXr8jmdrXwZI0R8raFICIsJzkUS6VgJyZDMkRRaJDShEcpkqFGUSxrKmNJMYZVFGAuk44xgEU3A_XFv3djPVrktLwsnlTGiUrZ1nDDIYtZ9PAHTo1E21rlGaV43RSmaAw8h7ynyDe9R8R4V7ynygSLfd-Hb4UqblSo_RQdsnf541HcdoMM_NvNZOn9hjES_GbGDeA</recordid><startdate>199810</startdate><enddate>199810</enddate><creator>Hemphill, Robin R.</creator><creator>Santen, Sally A.</creator><creator>Howell, John M.</creator><creator>Altieri, Michael F.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199810</creationdate><title>Follow‐up Compliance in Febrile Children: A Comparison of Two Systems</title><author>Hemphill, Robin R. ; Santen, Sally A. ; Howell, John M. ; Altieri, Michael F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4226-ff0a869465da83f4eac92cd2cafa878732bc1f23dc71c477be5eb355a2f4b65a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Child, Preschool</topic><topic>Continuity of Patient Care</topic><topic>Emergency Medical Services - standards</topic><topic>emergency medicine</topic><topic>Female</topic><topic>fever</topic><topic>Fever - therapy</topic><topic>follow‐up studies</topic><topic>Hospitals, Military</topic><topic>Hospitals, Urban</topic><topic>Humans</topic><topic>Infant</topic><topic>Insurance, Health</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Patient Compliance</topic><topic>pediatrics</topic><topic>Prospective Studies</topic><topic>United States</topic><topic>Virginia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hemphill, Robin R.</creatorcontrib><creatorcontrib>Santen, Sally A.</creatorcontrib><creatorcontrib>Howell, John M.</creatorcontrib><creatorcontrib>Altieri, Michael F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Academic emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hemphill, Robin R.</au><au>Santen, Sally A.</au><au>Howell, John M.</au><au>Altieri, Michael F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Follow‐up Compliance in Febrile Children: A Comparison of Two Systems</atitle><jtitle>Academic emergency medicine</jtitle><addtitle>Acad Emerg Med</addtitle><date>1998-10</date><risdate>1998</risdate><volume>5</volume><issue>10</issue><spage>996</spage><epage>1001</epage><pages>996-1001</pages><issn>1069-6563</issn><eissn>1553-2712</eissn><abstract>. 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 <24 hours after ED release. For FFX, self‐pay, lack of a follow‐up physician, parents' dissatisfaction with the ED medical care, and diagnosis of otitis media were also significant factors found associated with noncompliance.
Conclusion:Febrile children evaluated in a medical system with prearranged follow‐up appointments and free medical care are more likely to comply with recommended follow‐up than are those evaluated in a system where payment and appointments are the responsibility of the parents. Efforts should be made to improve follow‐up compliance by modeling the WHMC system.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>9862592</pmid><doi>10.1111/j.1553-2712.1998.tb02779.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library; Wiley Online Library Free Content; Free E-Journal (出版社公開部分のみ） |
| subjects | Child, Preschool Continuity of Patient Care Emergency Medical Services - standards emergency medicine Female fever Fever - therapy follow‐up studies Hospitals, Military Hospitals, Urban Humans Infant Insurance, Health Logistic Models Male Patient Compliance pediatrics Prospective Studies United States Virginia |
| title | Follow‐up Compliance in Febrile Children: A Comparison of Two Systems |
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