Variation in Follow-Up Visit Practices Across Clinicians and Conditions

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.