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Post-hospitalization followup appointment-keeping among the medically indigent

Abstract

The purpose of this study was to measure followup appointment-keeping in patients discharged from a General Medicine Inpatient Service and to identify possible predictors of compliance. Patients were interviewed on hospital admission and all charts were reviewed on discharge. A subset of patients were interviewed by telephone an average of one month after first followup appointment date. The study was conducted in an urban public teaching hospital with hospital-based and community clinics. A convenience sample of 209 patients were selected from admissions to the General Medicine Inpatient Service over a three month period. Followup appointment-keeping was recorded on all 195 patients discharged alive. Seventy-five percent of patients had no medical insurance, public or private. A compliance rate of 60% (95% confidence interval: 53% to 67%) with first followup appointment was found. Variables associated with compliance and which retained independence on multiple logistic regression analysis, followed by adjusted odds ratios (95% confidence intervals) were: no copayment requirement, odds ratio 3.2 (1.6 to 6.3), single followup appointment 2.9 (1.4 to 5.9), apartment dwelling 3.2 (1.4 to 7.3) and non-primary care clinic appointment 2.3 (1.1 to 4.8). We conclude that health-care-delivery related factors such as no copayment requirements are strongly associated with appointment-keeping in a public hospital population.

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Authors

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Correspondence to Catarina I. Kiefe PhD, MD.

Additional information

Catarina I. Kiefe, is Associate Professor of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA, and Prentiss L. Harrison, is Physician's Assistant, Department of Medicine, Ben Taub General Hospital and Baylor College of Medicine, Houston, Texas, USA

The authors thank David Hyman, M.D., M.P.H. for helpful suggestions and Ave Anderson for meticulous manuscript preparation.

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Kiefe, C.I., Harrison, P.L. Post-hospitalization followup appointment-keeping among the medically indigent. J Community Health 18, 271–282 (1993). https://doi.org/10.1007/BF01321788

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Keywords

  • Teaching Hospital
  • Adjusted Odds Ratio
  • Related Factor
  • Public Hospital
  • Public Teaching