{"pk":14265,"title":"Impact of Social Determinants of Health, Health Literacy, Self-perceived Risk, and Trust in the Emergency Physician  on Compliance with Follow-up","subtitle":null,"abstract":"Introduction:\n Patients presenting to the emergency department (ED) with “low-risk” acute coronary syndrome (ACS) symptoms can be discharged with outpatient follow-up. However, follow-up compliance is low for unknown nonclinical reasons. We hypothesized that a patient’s social factors, health literacy, self-perceived risk, and trust in the emergency physician may impact follow-up compliance.\nMethods: \nThis was a prospective study of a convenience sample of discharged ED patients presenting with chest pain and given a follow-up appointment prior to departing the ED. Patients were asked about social and demographic factors and to estimate their own risk for heart disease; they also completed the Short Assessment of Health Literacy-English (SAHL-E) and the Trust in Physician Scale (TiPS).\nResults:\n We enrolled146 patients with a follow-up rate of 36.3%. Patients who had a low self-perceived heart disease risk (10% or less) were significantly less likely to attend follow-up than those with a higher perceived risk (23% vs 44%, P = 0.01). Other factors did not significantly predict follow-up rates.\nConclusion:\n In an urban county ED, in patients who were deemed low risk for ACS and discharged, only self-perception of risk was associated with compliance with a follow-up appointment.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Emergency Medicine"},{"word":"Follow-up"},{"word":"Social Determinants"},{"word":"Health Literacy"},{"word":"Self-Perceived Risk"},{"word":"Compliance"}],"section":"Health Equity","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1kh6b7xd","frozenauthors":[{"first_name":"James","middle_name":"","last_name":"Sutton","name_suffix":"","institution":"University of Texas Southwestern School of Medicine, Dallas, Texas","department":"None"},{"first_name":"Leon","middle_name":"","last_name":"Gu","name_suffix":"","institution":"University of Texas Southwestern School of Medicine, Dallas, Texas","department":"None"},{"first_name":"Deborah","middle_name":"B.","last_name":"Diercks","name_suffix":"","institution":"University of Texas Southwestern, Department of Emergency Medicine, Dallas, Texas","department":"None"}],"date_submitted":"2020-07-07T03:26:40Z","date_accepted":"2020-07-07T03:26:40Z","date_published":"2021-05-05T18:23:45Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/14265/galley/7353/download/"}]}