Factors ID'd That Influence Lack of Orthopedic Follow-Up
(HealthDay News) – For patients treated in the emergency department, orthopedic-related and demographic variables influence failure to return for outpatient management ("no-show"), according to a study published in the Oct. 1 issue of The Journal of Bone & Joint Surgery.
Michelle M. Coleman, MD, from the University of North Carolina at Charlotte, and colleagues reviewed the charts of 464 consecutive adult patients who received an orthopedic consult in the emergency department. They assessed the correlations between injury type and management with no-show.
The researchers observed a 26.1% rate of no-show. Significant differences were seen in no-show rates based on the cause of injury (odds ratio [OR], 7.51), with the highest rate among assault victims. No-show rates were influenced by anatomic region of injury (OR, 6.61), with the highest rate for patients with a spine or back complaint. The orthopedic resident provider consulted influenced follow-up rates (OR, 10.8), but this was unrelated to training level (P=0.25). No-show rate was also affected by the type of bracing applied (OR, 2.46), with follow-up worsening with the ease of removing the brace (P=0.0001). Morbid obesity and current tobacco use were also predictive of clinic nonattendance (ORs, 15.0 and 5.56, respectively).
"These findings are useful in identifying patients at high risk for no-show to scheduled orthopedic follow-up appointments and may influence disposition and management decisions for these patients," the authors write.