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- Title
621 Discharge Survey of Burn Patients Reveals Concerns About Attending Follow up Appointments.
- Authors
Solomon, Eve A; Phelan, Elizabeth; Tumbaga, Lilia G; Karashchuk, Irina P; Greenhalgh, David G; Sen, Soman; Palmieri, Tina L; Romanowski, Kathleen S
- Abstract
Introduction Follow-up appointments are important after a burn injury to minimize adverse sequelae. A retrospective study at our institution revealed that over 25% of patients never attend a follow-up appointment. Failure to follow-up was associated with homelessness, drug use, and distance to the clinic. The purpose of this study was to design and administer a survey prior to discharge that seeks to identify patient-perceived barriers to follow-up. Methods A multidisciplinary team consisting of a burn surgeon, medical student, discharge planner, and social worker developed an 18-question survey that examined areas that might influence following up in burn clinic. There were questions regarding transportation, living situation, motivation to return for follow-up, homelessness, drug use, and social determinants of health. As a quality improvement project the surveys were administered to patients discharged following a burn injury by either the discharge planner or social worker from September 2019 to July 2020. Statistical analysis included descriptive statistics of survey responses. Results There were 473 patients discharged during the study period. A total of 342 patients completed surveys (72.3% response rate). Most patients (208, 60.8%) were very confident that they would come to a follow-up appointment and stated they had no obstacles to keeping their appointment. The most common obstacles stated were: transportation (143, 41.8%), cost (100, 29.2%), and time off work/school (70, 20.5%). The planned mode of transportation to appointments was being driven by someone else in a personal car (234, 68.4%), the second most common response was that they were unsure of their transportation (29, 8.5%). Patients traveled a great distance to come to the clinic with 188 patients (55%) traveling more than one hour. The most frequent discharge location was the patient's home (169, 49.4%), with the second most frequent being the home of a friend or family member (95, 27.8%). Sixty-two patients (18.1%) were homeless at the time of admission. When asked about their motivation for following up in clinic the most common response was concern about their injuries/healing (269, 78.7%). The most common levels of educational attainment were high school (149, 43.6%) and College (114, 33.3%). The most common employment status was unemployed (131, 38.3%) and 141 patients (41.2%) made less than $25,000 per year. With respect to substance use, 171 (50%) patients used alcohol, 151 (44.2%) patients smoked, and 82 (24%) patients used illicit drugs. Conclusions Many patients are motivated to come to their follow-up appointments but face significant difficulties in coming to appointments due to distance to the clinic, transportation, and cost issues.
- Subjects
BURN patients; DRUG utilization; PATIENT surveys; SUBSTANCE abuse; HOSPITAL admission &; discharge
- Publication
Journal of Burn Care & Research, 2021, Vol 42, pS165
- ISSN
1559-047X
- Publication type
Article
- DOI
10.1093/jbcr/irab032.271