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M. Harris, C. A. Rosende, B. H. Pollock, C. S. Ballentine; Incidence of Follow-up Examinations Within a Remote Diabetic Screening Program. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2506.
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Diabetes affects the eyes of millions of Americans. Bexar County, located in South Texas, has an estimated 70,000 diabetics. To meet eye care demands, UTHSCSA Department of Ophthalmology implemented a remote photo-screening site at a primary care clinic. Over a 1 year span, > 1,000 diabetic patients have been screened, but it is unknown how many patients were then scheduled an exam based on suspected pathology or how many comply with this appointment. Our aim is to evaluate the cumulative incidence of follow-up within a 6 month period and predict no-show rates based on various factors.
Retrospective review of 1,542 records with respective follow-up recommendations: ASAP, 3 months, 6 months, 9 months, and 12 months. Patients from the first three groups were identified: "scheduled within recommended follow-up," "scheduled within 6 months, but outside recommended follow-up," "scheduled > 6 months," "no appointment." No-show/cancellation, insurance status, and other demographic data (age, # yrs diabetic, etc.) was annotated. 9 and 12 month recommendations were omitted since these patients returned to the remote screening pool.
Of 1,542 records, 287 (18%) patients were referred for an ASAP appointment, 244 (15%) patients for 3 month exam, 133 (8%) for 6 month exam. The remainder was recommended repeat screening at 9 or 12 months.664 patients were recommended a follow-up exam within 6 months of screening. Of these:-66 (10%) were scheduled within the recommended follow-up period.-265 (40%) were scheduled within 6mo, but outside the recommended follow-up time.-200 (30%) were scheduled > 6 mo from screening.-133 (20%) patients had no appointment found.-Of these 529 patients, 90 (17%) patients did not show or cancelled their appointment.-All but one patient had medical insurance.
The cumulative incidence of a patient being scheduled within 6 months of screening is approximately 50%. There is a large portion of patients not scheduled within the recommended screening time (10%) and a greater number not scheduled at all (20%). If scheduled, most patients comply with follow-up and medical insurance does not appear to affect compliance. Analysis of factors predicting "no-shows" is pending.
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