Profile of the patient who drops out of neuropediatric follow-up
Correspondencia: Dra. Carmen Garaizar. Sección de Neuropediatría. Hospital de Cruces. Plaza de Cruces, s/n. E-48903 Baracaldo, Vizcaya.
E-mail: cgaraizar@hcru.osakidetza.net
Introduction: Patients who drop out of programmed follow-up cause adverse effects to both themselves and the running of the medical.
Objective: To obtain information which would permit us to modify guidelines for medical care in cases with particular diagnoses, so as to avoid interrupting follow-up.
Patients and methods: We selected all the patients who attended during 1995, and on 31 December 1995 had not been discharged or died. We considered a patient to have dropped out of follow-up when there was failure to attend the centre during two consecutive years without a justifiable reason. Logistic regression analysis was used to determine the profile of the patients who dropped out of follow-up.
Results: Of the patients attended during one year and whose treatment should have been continued, 16% dropped out; 70% of those who dropped out of their follow-up treatment were somewhat older than the rest and came in particular from two of the five health districts of the province. They had tics, tension headaches and migraine. Only three independent factors are associated with dropping out: absence of complementary tests, which is favorable, and epilepsy or previous long-term follow-up which is unfavorable.
Conclusion: Reduction in the programmed follow-up of patients with conditions which do not require complementary tests may reduce the drop out rate and improve the functioning of the Neuropaediatric Clinic.
Objetivo Obtener información que nos permita modificar las pautas asistenciales ante diagnósticos concretos, para evitar la interrupción del seguimiento.
Pacientes y métodos Seleccionamos a todos los pacientes atendidos durante 1995, que al 31 de diciembre de 1995 no hubieran sido dados de alta ni fallecido. Consideramos abandono definitivo del seguimiento al hecho de no haber acudido a la consulta durante dos años seguidos sin motivo justificado. Utilizamos la regresión logística para elaborar el perfil del paciente que abandona.
Resultados Abandonaron el 16% de los pacientes atendidos durante un año y cuyo seguimiento debería haber continuado; el 70% abandonan durante su primer año de seguimiento, son algo más mayores y proceden sobre todo de dos de las cinco comarcas sanitarias de la provincia. Padecen tics, cefaleas tensionales y migraña. Hay solamente tres factores independientes asociados al abandono: la carencia de exámenes complementarios, que lo favorece, y la epilepsia o un seguimiento previo más largo, que previenen contra el mismo.
Conclusión Reducir el seguimiento programado de los padecimientos que no requieren la práctica de exámenes complementarios puede disminuir la tasa de abandonos y mejorar el rendimiento asistencial de la consulta neuropediátrica
