AN ANALYSIS OF SOCIAL AND ECONOMIC-FACTORS ASSOCIATED WITH FOLLOW-UP OF PATIENTS WITH VESICOURETERAL REFLUX

Purpose: Nonsurgical treatment of vesicoureteral reflux requires antib iotic prophylaxis and long-term surveillance. We examined factors that affect followup compliance and influence quality of care in these chi ldren. Materials and Methods: We retrospectively reviewed the records of 288 boys and 742 girls with vesicoureteral reflux. Results: Of the children treated nonsurgically for vesicoureteral reflux 34% were lost to followup and the majority (80%) were not monitored beyond the 1-ye ar followup appointment. Older maternal age (36 years or older) was si gnificantly associated with improved followup compliance. Paternal age , primary physician type, medical insurance type, income, education le vel and environment (urban, suburban or rural) were not significant. C onclusions: Approximately a third of children treated nonsurgically fo r vesicoureteral reflux will be lost to followup, Only older maternal age predicts for good compliance. Preconceptions about compliance on t he basis of other factors, such as socioeconomic status and primary ph ysician type, may be incorrect. Furthermore, the notion that certain f orms of medical insurance plans may help to promote followup may also be unsupported. These children would benefit from efforts to improve c ompliance with a medical regimen or early correction of reflux.