TELEPHONE FOLLOW-UP OF PATIENTS DISCHARGED FROM THE EMERGENCY DEPARTMENT - HOW RELIABLE

As the result of the current emphasis on health care cost containment, outpatient management of entities previously in the domain of inpatie nt therapy is being proposed, The advocates of this approach stress th e importance of telephone follow-up in patients chosen for outpatient therapy, Our objective was to determine the reliability of phone follo w-up in patients discharged from the emergency department (ED), We att empted to contact by phone 250 consecutive children evaluated and disc harged from Loyola University Medical Center Emergency Department, A m aximum of six attempts per patient was made starting within 72 hours o f the ED visit, Calls were placed to home, work, and contact numbers p rovided at the time of the ED visit, and messages were left on answeri ng machines or with persons who answered the phone, The time needed to reach the guardian was calculated from the time of the first call unt il successful contact of the guardian, We were successful in contactin g 68.4% of our study subjects, Patients with commercial insurance were contacted more often than those with other types of insurance, A mean of 1.61 +/- 1.09 calls were needed to reach the guardians who were su ccessfully contacted, and the mean time required was 3.14 +/- 7.25 hou rs, Medical indication for telephone follow-up, as determined by the m anaging physician, did not influence our ability to reach the study su bjects, In view of our moderate success rate in reaching patients disc harged from the ED, we advocate caution in the implementation of outpa tient strategies in the management of febrile children who are at high risk for life-threatening complications.