Compliance with outpatient follow-up recommendations for infants at risk for retinopathy of prematurity

Objectives: We undertook this study to determine how frequently at-risk infants were scheduled for and brought to follow-up appointments for retinopathy of prematurity (ROP) examination after hospital discharge and to identify barriers to follow-up. Methods: The records of 126 infants with or at risk for ROP at the time of hospital discharge were retrospectively reviewed. Data recorded included the presence or absence of a timely outpatient follow-up appointment, the identity of the person who scheduled the appointment (hospital staff or parents), attendance rate for appointments made, race or ethnicity, and insurance status. Results: Sixty-two of 126 (49%) infants were scheduled for a timely outpatient examination. Sixty-four of 126 (51%) required telephone contact from our office to be scheduled for an appointment. Eight of 21 (38%) African American infants had an appointment scheduled without additional intervention by our office personnel, and 6 of 21 (29%) were brought to an appointment in a timely manner. Twenty-two of 33 (68%) white infants had an appointment scheduled without additional intervention by our office personnel, and 20 of 33 (61%) were brought to an appointment in a timely manner. African American patients were less likely than white patients to be brought to a follow-up appointment (P = ,022). Eleven of 15 (73%) patients, whose appointments were scheduled by hospital personnel before discharge, were brought to their follow-up appointment, compared with 39 of 105 (37%) patients, whose parents were requested to schedule their own appointment (P = .008). Conclusion: Almost 50% of infants with or at risk for ROP were not scheduled for a timely outpatient follow-up appointment, putting these neonates at risk for ROP-related blindness, Patients whose appointments were scheduled by hospital personnel before discharge were more likely to be brought to a follow-up examination. Extensive utilization of office support staff was required to ascertain the status of infants who did not have appointments scheduled or who were not brought to follow-up appointments.