TY - JOUR
T1 - Barriers to outpatient stress testing follow-up for low-risk chest pain patients presenting to an ED chest pain unit
AU - Story, Margaret
AU - Reynolds, Bradford
AU - Bowser, Meghan
AU - Xu, Hongyan
AU - Lyon, Matthew
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Introduction Outpatient stress testing (OST) after evaluation in the emergency department (ED) is an acceptable evaluation method for patients presenting to the ED with low-risk chest pain (CP). However, not all patients return for OST. Barriers to follow-up evaluation exist and are poorly understood. In this study, we examined the influence of demographic and social characteristics on OST compliance. Methods Data were collected on low-risk CP patients with scheduled OSTs. OST compliance was assessed and then analyzed for correlation with potential barriers including insurance type; age; sex; race; employment status; the distance the patient lived from the hospital; whether or not the patient had a primary care physician; whether or not the patient had a history of hypertension or diabetes; and whether or not the patient had a history of tobacco, alcohol, or illicit drug use. Results A total of 275 patients were enrolled over a 5-month period. These patients had an OST follow-up rate of 61.82% within 72 hours of discharge from the ED. Patients with Medicaid were statistically less likely (odds ratio [OR], 0.439) to complete OST. Patients with commercial insurance (OR, 1.8225), who were employed (OR, 2.299), or who were retired (OR, 3.44) were more likely to complete OST. All of the other variables analyzed were not statistically significant factors in OST compliance. Conclusion More than one-third of low-risk CP patients do not follow-up with scheduled OST. Of the variables analyzed, both employment status and insurance type were statistically significant and should be included in risk stratification strategies for OST.
AB - Introduction Outpatient stress testing (OST) after evaluation in the emergency department (ED) is an acceptable evaluation method for patients presenting to the ED with low-risk chest pain (CP). However, not all patients return for OST. Barriers to follow-up evaluation exist and are poorly understood. In this study, we examined the influence of demographic and social characteristics on OST compliance. Methods Data were collected on low-risk CP patients with scheduled OSTs. OST compliance was assessed and then analyzed for correlation with potential barriers including insurance type; age; sex; race; employment status; the distance the patient lived from the hospital; whether or not the patient had a primary care physician; whether or not the patient had a history of hypertension or diabetes; and whether or not the patient had a history of tobacco, alcohol, or illicit drug use. Results A total of 275 patients were enrolled over a 5-month period. These patients had an OST follow-up rate of 61.82% within 72 hours of discharge from the ED. Patients with Medicaid were statistically less likely (odds ratio [OR], 0.439) to complete OST. Patients with commercial insurance (OR, 1.8225), who were employed (OR, 2.299), or who were retired (OR, 3.44) were more likely to complete OST. All of the other variables analyzed were not statistically significant factors in OST compliance. Conclusion More than one-third of low-risk CP patients do not follow-up with scheduled OST. Of the variables analyzed, both employment status and insurance type were statistically significant and should be included in risk stratification strategies for OST.
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U2 - 10.1016/j.ajem.2015.12.083
DO - 10.1016/j.ajem.2015.12.083
M3 - Article
C2 - 26853618
AN - SCOPUS:84957101948
SN - 0735-6757
VL - 34
SP - 790
EP - 793
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 5
ER -