The relation between regular outpatient follow-up and frequency of emergency department visits in sickle cell pediatric patients

Abstract

Objective: To evaluate the relationship between the frequency of ED visits and outpatient department (OPD) follow-up in sickle cell disease (SCD) pediatric patients.

Methods: A retrospective cohort study included 247 SCD pediatric patients between January 2016 and December 2018 at the Maternity and Children Hospital, Department of Pediatrics, Al Medinah Al Munawarah, Saudi Arabia. Data were extracted from electronic medical record system; patient demographics, medications, frequency of emergency department (ED) and OPD visits. Pearson correlation coefficient, linear regression and independent sample t-test were applied.

Results: There was no significant correlation (95% CI [-0.013- 0.233]; p=0.07) between the frequency of ED and OPD visits. However, a significant correlation was found between ED visits and missed OPD appointments. Thus, linear regression was applied and indicated that one missed OPD appointment is associated with 1.92 ED visits, (95% CI: 0.19-0.42; p less than 0.001). Also, a higher rate of ED visits was observed when compared with other studies, with a high ED reliance of 43%.

Conclusion: This study found that regular OPD visits could improve SCD management, as a directly proportional relationship between the frequency of ED visits and missed OPD appointments along with high ED reliance.

Figure 1

Prediction of the frequency of expected emergency department (ED) visits through the missed appointment by the following linear regression equation: frequency of ED visits = 4.728+1.920× missed outpatient department (OPD) appointments for hematology clinic. R=0.31.