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Lost but not missing: factors associated with loss of follow-up in a paediatric cardiology clinic

Published online by Cambridge University Press:  02 September 2021

Lisa J. Gregorcyk Open the ORCID record for Lisa J. Gregorcyk [Opens in a new window] ,
Michael Kelleman  and
Matthew E. Oster
Lisa J. Gregorcyk
Affiliation:
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
Michael Kelleman
Affiliation:
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
Matthew E. Oster*
Affiliation:
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA Children’s Healthcare of Atlanta, Atlanta, GA, USA
*
Author for correspondence: M. E. Oster, MD, MPH, Children’s Healthcare of Atlanta, Emory University School of Medicine, 2835 Brandywine Road, Suite 300, Atlanta, GA 30341, USA. Tel: +1-404-256-2593. E-mail: [email protected]
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Abstract

Background:

Loss of follow-up is a barrier to providing adequate care to paediatric cardiac patients. The purpose of this study was to determine variables associated with loss of appropriate paediatric cardiology follow-up, including potentially modifiable factors. We hypothesised having earlier recommend follow-up intervals was associated with less likelihood of loss of follow-up.

Methods:

We performed a retrospective cohort study of patients >5 years old seen in a large, outpatient paediatric practice from 2013 to 2016. Subjects were considered to be lost to follow-up if they did not have a subsequent outpatient encounter by 6 months after their recommend follow-up time interval.

Results:

Of the 8940 eligible patients, 45.9% were lost to follow-up. Recommended follow-up interval of 1 year was associated with less loss of follow-up (41.4%) as compared to 2-year intervals (51.6%) and 3 years (55.7%) (p < 0.001 for both). Other significant predictors of loss of follow-up included less severe heart disease, older age, and non-Hispanic Black race/ethnicity. Sex and payor type were not significant predictors. In the stratified analyses by severity of disease and age, longer recommended follow-up time was associated with greater loss of follow-up among all severity and age categories.

Conclusions:

Almost half of the patients in our cohort did not return to clinic within the recommended timeline. Shorter follow-up time was associated with less loss of follow-up among all categories of disease severity and age groups. Recommending shorter follow-up intervals may be one initiative for paediatric cardiologists to improve rates of follow-up.

Keywords

Lost to follow-uploss of follow-upCHD
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 7 , July 2022 , pp. 1061 - 1065
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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