Adjusting follow-up intervals in a diabetic clinic: Implications for costs and quality of care

Abstract

One of the main determinants of cost in the follow-up of patients with chronic disease is the frequency with which they are seen in out-patient clinics. The implementation of clinical information systems allows this relationship to be investigated and rationalised. Such potential uses of clinical information systems should be considered when evaluating the costs and benefits of implementation. In 2,226 diabetic clinic attenders, of ten variables studied, the doctor seen was one of the most consistent significant predictors (P<0.001) of follow-up intervals and many patients were seen more often than was probably necessary. An increase of 30 per cent in all follow-up intervals would be clinically acceptable and would allow nearly 2,000 known non-attenders to be given a biannual examination. The increase in total annual costs would probably be less than 5 per cent.