Variation in Follow-Up Visit Practices Across Clinicians and Conditions: Findings From a University Cardiology Practice

Abstract

Background: Specialty care access is increasingly constrained due to increasing demand for specialty care. Although much attention has been placed on the initial referral decision, much less is known about follow-up visit patterns. We examined the patterns of follow-up visits for new patients to a university-based cardiology practice and identified independent predictors of follow-up visits. Methods: This is a retrospective cohort study of new patient visits using electronic medical record data. The primary outcome was a follow-up visit. Results: Substantial variation in practice patterns by provider persisted after accounting for patient and disease factors. Most follow-up care was concentrated in a small population of patients. Conclusion: Specialty care follow-up visits may represent a significant opportunity for standardization and quality improvement, and further studies are warranted to understand follow-up visits in specialty care. Implications: Better understanding of between-provider differences could identify ways to reduce unnecessary follow-up visits. Level of Evidence: Single-institution study.