Lost but not missing: factors associated with loss of follow-up in a paediatric cardiology clinic

2021 ◽  
pp. 1-5
Author(s):  
Lisa J. Gregorcyk ◽  
Michael Kelleman ◽  
Matthew E. Oster
Keyword(s):  
Age Groups ◽  
Time Interval ◽  
Paediatric Cardiology ◽  
Adequate Care ◽  
Modifiable Factors ◽  
Cardiology Clinic ◽  
Paediatric Practice ◽  
Race Ethnicity ◽  
Lost To Follow Up

Abstract Background: Loss of follow-up is a barrier to providing adequate care to paediatric cardiac patients. The purpose of this study was to determine variables associated with loss of appropriate paediatric cardiology follow-up, including potentially modifiable factors. We hypothesised having earlier recommend follow-up intervals was associated with less likelihood of loss of follow-up. Methods: We performed a retrospective cohort study of patients >5 years old seen in a large, outpatient paediatric practice from 2013 to 2016. Subjects were considered to be lost to follow-up if they did not have a subsequent outpatient encounter by 6 months after their recommend follow-up time interval. Results: Of the 8940 eligible patients, 45.9% were lost to follow-up. Recommended follow-up interval of 1 year was associated with less loss of follow-up (41.4%) as compared to 2-year intervals (51.6%) and 3 years (55.7%) (p < 0.001 for both). Other significant predictors of loss of follow-up included less severe heart disease, older age, and non-Hispanic Black race/ethnicity. Sex and payor type were not significant predictors. In the stratified analyses by severity of disease and age, longer recommended follow-up time was associated with greater loss of follow-up among all severity and age categories. Conclusions: Almost half of the patients in our cohort did not return to clinic within the recommended timeline. Shorter follow-up time was associated with less loss of follow-up among all categories of disease severity and age groups. Recommending shorter follow-up intervals may be one initiative for paediatric cardiologists to improve rates of follow-up.

scholarly journals An Evaluation of Survival of Space Maintainers: A Six-year Follow-up Study

2005 ◽  
Vol 6 (1) ◽  
pp. 74-84 ◽  
Author(s):  
Ozlem Tulunoglu ◽  
Tezer Ulusu ◽  
Yasemin Genç
Keyword(s):  
Survival Time ◽  
Success Rate ◽  
Median Survival ◽  
Median Survival Time ◽  
Age Groups ◽  
Age Group ◽  
Follow Up Study ◽  
Different Types ◽  
Lost To Follow Up

Abstract The aim of this study was to evaluate the median survival time of fixed and removable space maintainers related to age groups, gender, and their distribution in upper and lower dental arches. The adherence of patients to a periodic recall program and the success rate of different types of space maintainers related to different arches were also evaluated. This study included 663 patients aged between 4-15 years old that were treated between the years of 1997 and 2002. The patients were categorized into four main groups: lost to follow-up, failed, successful, and censored at the end of study. Three hundred forty-five space maintainers were considered lost to follow-up, 83 were considered failed, 206 successful, and 20 censored-at-end. The overall median survival time of the appliances was 6.51 months. Median survival time was 7.25 months in the 4-6 age group, 6.35 months in the 7-12 age group, and 7.0 months in the 13+ age groups. Median survival time was 5.76 months in girls and 7.11 months in boys. Median survival time of space maintainers was 7.17 months for maxilla and 6.69 months in the mandible. Median survival time was 5.25 months for space maintainers fabricated in both arches. Citation Tulunoglu Ö, Ulusu T, Genç Y. An Evaluation of Survival of Space Maintainers: A Six-year Follow-up Study J Contemp Dent Pract 2005 February;(6)1:074-084.

WHO IS LOST TO FOLLOW-UP?

PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. A38-A38
Author(s):  
Student
Keyword(s):  
High Risk ◽  
Major Effect ◽  
Dropout Rates ◽  
Time Interval ◽  
Environmental Characteristics ◽  
Developmental Status ◽  
Loss To Follow Up ◽  
High Risk Infants ◽  
Lost To Follow Up

The belief that impaired infants are more likely to continue in follow-up is. . .not supported. The infant's developmental status significantly influenced loss to follow-up only between the 18-to 36-month time interval. Here, more babies in the dubious (vs abnormal) category withdrew. In general our findings suggest that environmental characteristics exert the major effect on dropout rates in high risk infants and their controls.

Challenges of intra-institutional transfer of care from paediatric to adult congenital cardiology: the need for retention as well as transition

2015 ◽  
Vol 26 (2) ◽  
pp. 327-333 ◽  
Author(s):  
Claudine M. Bohun ◽  
Patricia Woods ◽  
Christiane Winter ◽  
Julie Mitchell ◽  
Joel McLarry ◽  
...  
Keyword(s):  
Information Exchange ◽  
Adult Congenital Heart Disease ◽  
Care Providers ◽  
Single Institution ◽  
Adult Care ◽  
Cardiology Clinic ◽  
Adult Congenital ◽  
Lost To Follow Up ◽  
Successful Transfer

AbstractBackgroundTransferring patients with CHD from paediatric to adult care has been challenging, especially across institutions. Within a single institution, some issues such as provider interaction, information exchange, or administrative directives should not play a significant role, and should favour successful transfer.ObjectiveWe studied patients who were eligible for transfer to the adult congenital heart disease service within our institution in order to identify factors associated with successful transfer to adult care providers versus failure to transfer.MethodsPatients above18 years of age with CHD who were seen by paediatric cardiologists before January, 2008 were identified through a patient-care database. Records were reviewed to determine follow-up between 2008 and 2011 and to determine whether the patient was seen in the adult congenital cardiology clinic, paediatric cardiology clinic, or had no follow-up, and statistical comparisons were made between groups.ResultsAfter reviewing 916 records, 229 patients were considered eligible for transition to adult congenital cardiology. Of these, 77 (34%) were transferred successfully to adult congenital cardiology, 47 (21%) continued to be seen by paediatric cardiologists, and 105 (46%) were lost to follow-up. Those who transferred successfully differed with regard to complexity of diagnosis, insurance, and whether a formal referral was made by a paediatric care provider. Only a small fraction of the patients who were lost to follow-up could be contacted.ConclusionWithin a single institution, with shared information systems, administrations, and care providers, successful transfer from paediatric to adult congenital cardiology was still poor. Efforts for successful retention are just as vital as those for transfer.

scholarly journals [Value of immunization data analysis at the district level]

1999 ◽  
Vol 5 (3) ◽  
pp. 565-571
Author(s):  
M. S. Soltani
Keyword(s):  
Health Professionals ◽  
Time Interval ◽  
Immunization Schedule ◽  
Improve Performance ◽  
Time Intervals ◽  
Health Centres ◽  
Prevention Programmes ◽  
National Prevention ◽  
Lost To Follow Up

This study aimed to demonstrate the importance of analysing local immunization data to improve performance of national prevention programmes. From the immunization registers kept in basic health centres, we identified 1271 children receiving their first vaccine at 3 months. Examination of the age at the subsequent vaccinations and time intervals between vaccinations showed that 81.9% had received all the vaccines required by the Ministry of Health but only 48.5% had received immunization meeting the requirements for age and time interval. The analysis also helped identify health centres with best performance [fewer children lost to follow-up and better implementation of immunization schedule]and those vaccinations needing the greatest attention from health professionals

scholarly journals Discontinuation of follow-up care for young people with complex chronic conditions: conceptual definitions and operational components

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sandra Skogby ◽  
Ewa-Lena Bratt ◽  
Bengt Johansson ◽  
Philip Moons ◽  
Eva Goossens
Keyword(s):  
Young People ◽  
Chronic Conditions ◽  
Time Interval ◽  
Complex Chronic Conditions ◽  
Time Period ◽  
Core Set ◽  
Follow Up Care ◽  
Care Gaps ◽  
Lost To Follow Up

Abstract Background A substantial proportion of young people with Complex Chronic Conditions (CCCs) experience some degree of discontinuation of follow-up care, which is an umbrella term to describe a broken chain of follow-up. Discontinuation of follow-up care is not clearly defined, and the great plethora of terms used within this field cannot go unnoticed. Terms such as “lost to follow-up”, “lapses in care” and “care gaps”, are frequently used in published literature, but differences between terms are unclear. Lack of uniformity greatly affects comparability of study findings. The aims of the present study were to (i) provide a systematic overview of terms and definitions used in literature describing discontinuation of follow-up care in young people with CCC’s; (ii) to clarify operational components of discontinuation of follow-up care (iii); to develop conceptual definitions and suggested terms to be used; and (iv) to perform an expert-based evaluation of terms and conceptual definitions. Methods A systematic literature search performed in PubMed was used to provide an overview of current terms used in literature. Using a modified summative content analysis, operational components were analysed, and conceptual definitions were developed. These conceptual definitions were assessed by an expert panel using a survey. Results In total, 47 terms and definitions were retrieved, and a core set of operational components was identified. Three main types of discontinuation of follow-up care emerged from the analysis and expert evaluation, conceptually defined as follows: Lost to follow-up care: “No visit within a defined time period and within a defined context, and the patient is currently no longer engaged in follow-up care”;Gap in follow-up care: “Exceeded time interval between clinic visits within a defined context, and the patient is currently engaged in follow-up care”; andUntraceability: “Failure to make contact due to lack of contact information”. Conclusion By creating a common vocabulary for discontinuation of follow-up care, the quality of future studies could improve. The conceptual definitions and operational components provide guidance to both researchers and healthcare professionals focusing on discontinuation of follow-up care for young people with CCCs.

scholarly journals Functional outcome in distal third tibial fractures treated with interlocking nailing

2016 ◽  
Vol 2 (3) ◽  
pp. 91
Author(s):  
K. Thanigaimani
Keyword(s):  
Functional Outcome ◽  
Tibial Fractures ◽  
Time Interval ◽  
Orthopaedic Department ◽  
Distal Tibial Fractures ◽  
Non Union ◽  
Interlocking Nailing ◽  
Nail Removal ◽  
Lost To Follow Up

<p class="abstract"><strong>Background:</strong> The purpose of this study was to evaluate the functional outcome in distal third tibial fractures not extending into the ankle joint treated with interlocking nailing.</p><p class="abstract"><strong>Methods:</strong> Twenty eight patients of distal tibial fractures were admitted in our orthopaedic department .5 patients were lost to follow up. Hence 23 patients were studied. After initial resuscitation and immobilization, they were taken up for internal fixation. Depending upon their general condition and associated injuries the time interval for surgery varied from one day to two weeks. They were periodically followed at 6 weeks, 3<sup>rd</sup> month, 4<sup>th</sup> month, 6<sup>th</sup> month and every eight weeks thereafter, till fracture union.<strong></strong></p><p class="abstract"><strong>Results:</strong> No patient in the study went in for non-union. All the fractures united well. However two patients had osteomyelitis which was settled after nail removal and appropriate antibiotics. One had ankle stiffness. The outcome was analysed with Johner and Wruh criteria.</p><strong>Conclusions:</strong> The outcome of treatment of distal tibial fractures is mostly affected by the severity of the injury and associated complications or injury. The study showed that interlocking nailing gives good results in distal third tibial fractures.

Lost to Follow-Up

2009 ◽  
Vol 40 (12) ◽  
pp. 13
Author(s):  
ALAN ROCKOFF
Keyword(s):  
Lost To Follow Up

Predicting the risk of becoming lost to follow-up in a lifestyle weight-loss intervention

2013 ◽  
Author(s):  
Danielle M. Lespinasse ◽  
Kristen E. Medina ◽  
Stacey N. Maurer ◽  
Samantha A. Minski ◽  
Renee T. Degener ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Loss Intervention ◽  
Lost To Follow Up

Management of Haemophilia in Sweden

1976 ◽  
Vol 35 (03) ◽  
pp. 510-521 ◽  
Author(s):  
Inga Marie Nilsson
Keyword(s):  
Factor Viii ◽  
Total Population ◽  
Age Groups ◽  
Factor Ix ◽  
Haemophilia A ◽  
Severe Haemophilia ◽  
Haemophilia B ◽  
Human Fraction ◽  
Mild Haemophilia

SummaryThe incidence of living haemophiliacs in Sweden (total population 8.1 millions) is about 1:15,000 males and about 1:30,000 of the entire population. The number of haemophiliacs born in Sweden in 5-year periods between 1931-1975 (June) has remained almost unchanged. The total number of haemophilia families in Sweden is 284 (77% haemophilia A, 23% haemophilia B) with altogether 557 (436 with A and 121 with B) living haemophiliacs. Of the haemophilia A patients 40 % have severe, 18 % moderate, and 42 % mild, haemophilia. The distribution of the haemophilia B patients is about the same. Inhibitors have been demonstrated in 8% of the patients with severe haemophilia A and in 10% of those with severe haemophilia B.There are 2 main Haemophilia Centres (Stockholm, Malmo) to which haemophiliacs from the whole of Sweden are admitted for diagnosis, follow-up and treatment for severe bleedings, joint defects and surgery. Minor bleedings are treated at local hospitals in cooperation with the Haemophilia Centres. The concentrates available for treatment in haemophilia A are human fraction 1-0 (AHF-Kabi), cryoprecipitate, Antihaemophilic Factor (Hyland 4) and Kryobulin (Immuno, Wien). AHF-Kabi is the most commonly used preparation. The concentrates available for treatment in haemophilia B are Preconativ (Kabi) and Prothromplex (Immuno). Sufficient amounts of concentrates are available. In Sweden 3.2 million units of factor VIII and 1.0 million units of factor IX are given per year. Treatment is free of charge.Only 5 patients receive domiciliary treatment, but since 1958 we in Sweden have practised prophylactic treatment of boys (4–18 years old) with severe haemophilia A. At about 5-10 days interval they receive AHF in amounts sufficient to raise the AHF level to 40–50%. This regimen has reduced severe haemophilia to moderate. The joint score is identical with that found in moderate haemophilia in the same age groups. For treatment of patients with haemophilia A and haemophilia B complicated by inhibitors we have used a large dose of antigen (factor VIII or factor IX) combined with cyclophosphamide. In most cases this treatment produced satisfactory haemostasis for 5 to 30 days and prevented the secondary antibody rise.

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