TY - JOUR
T1 - Impact of social determinants of health, health literacy, self-perceived risk, and trust in the emergency physician on compliance with follow-up
AU - Sutton, James
AU - Gu, Leon
AU - Diercks, Deborah B.
N1 - Publisher Copyright:
© 2021 eScholarship. All rights reserved.
PY - 2021/5
Y1 - 2021/5
N2 - Introduction: Patients presenting to the emergency department (ED) with "low-risk" acute coronary syndrome (ACS) symptoms can be discharged with outpatient follow-up. However, follow-up compliance is low for unknown nonclinical reasons. We hypothesized that a patient's social factors, health literacy, self-perceived risk, and trust in the emergency physician may impact follow-up compliance. Methods: This was a prospective study of a convenience sample of discharged ED patients presenting with chest pain and given a follow-up appointment prior to departing the ED. Patients were asked about social and demographic factors and to estimate their own risk for heart disease; they also completed the Short Assessment of Health Literacy-English (SAHL-E) and the Trust in Physician Scale (TiPS). Results: We enrolled146 patients with a follow-up rate of 36.3%. Patients who had a low self-perceived heart disease risk (10% or less) were significantly less likely to attend follow-up than those with a higher perceived risk (23% vs 44%, P = 0.01). Other factors did not significantly predict follow-up rates. Conclusion: In an urban county ED, in patients who were deemed low risk for ACS and discharged, only self-perception of risk was associated with compliance with a follow-up appointment.
AB - Introduction: Patients presenting to the emergency department (ED) with "low-risk" acute coronary syndrome (ACS) symptoms can be discharged with outpatient follow-up. However, follow-up compliance is low for unknown nonclinical reasons. We hypothesized that a patient's social factors, health literacy, self-perceived risk, and trust in the emergency physician may impact follow-up compliance. Methods: This was a prospective study of a convenience sample of discharged ED patients presenting with chest pain and given a follow-up appointment prior to departing the ED. Patients were asked about social and demographic factors and to estimate their own risk for heart disease; they also completed the Short Assessment of Health Literacy-English (SAHL-E) and the Trust in Physician Scale (TiPS). Results: We enrolled146 patients with a follow-up rate of 36.3%. Patients who had a low self-perceived heart disease risk (10% or less) were significantly less likely to attend follow-up than those with a higher perceived risk (23% vs 44%, P = 0.01). Other factors did not significantly predict follow-up rates. Conclusion: In an urban county ED, in patients who were deemed low risk for ACS and discharged, only self-perception of risk was associated with compliance with a follow-up appointment.
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U2 - 10.5811/westjem.2020.12.48981
DO - 10.5811/westjem.2020.12.48981
M3 - Article
C2 - 34125044
AN - SCOPUS:85108240596
SN - 1936-900X
VL - 22
SP - 667
EP - 671
JO - Western Journal of Emergency Medicine
JF - Western Journal of Emergency Medicine
IS - 3
ER -