How well do patients obtain short-term follow-up after discharge from the emergency department?

Study objective: We sought to determine the follow-up rate of discharged em ergency department patients who were instructed to obtain reevaluation with in 48 hours at our ED, a clinic, or a private physician's office and to det ermine the reasons why patients do not obtain short-term follow-up when ins tructed. Methods: Emergency physicians prospectively enrolled a convenience sample o f patients discharged from a university hospital ED who were believed to be at risk for clinical deterioration. Patients were instructed to obtain ree valuation within 48 hours at a public clinic, private physician's office, o r our ED (without charge). A telephone interview was conducted after 48 hou rs had elapsed. Results: Three hundred twenty-five patients were enrolled, 300 were include d in data analysis, and 203 (67.7%) of these obtained follow-up as instruct ed. Those referred to the ED had a higher follow-up rate (105/127 [82.7%]) than those referred to clinics (59/99 [59.6%]) or private physicians (39/74 [52.7%]). Inability to obtain an appointment was cited by 34.3% of those w ho did not obtain follow-up care as instructed. Conclusion: Many patients discharged from the ED who were believed to be at risk for clinical deterioration did not obtain medical follow-up within 48 hours when so instructed. Free ED follow-up resulted in a better rate of s hort-term followup than that for clinics and private physicians and may be especially useful if a patient's ability to obtain follow-up is uncertain o r if timely reevaluation is particularly imperative.