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Stroke is the fifth leading cause of death in the US and a leading cause of long-term disability. Outpatient follow-up is a critical component of overall stroke care.  Compliance with follow-up may impact morbidity and mortality, medication adherence, recurrent stroke risk, and quality of life. Transitions of Care (TOC) assessment aims to address potential needs of patients as they move from one environment of care to another.  Appointment within 14 days of discharge is required to meet TOC definition by CMS.

This is a single center retrospective review comparing appointment adherence rates of patients discharged with a prior diagnosis of TIA, ischemic stroke, or hemorrhagic stroke. Group 1 were those discharged home between June-September 2018 and scheduled for follow up in the TOC Clinic within 14 days [n=169, age (median ± SD) 60 ± 14 years; 55% female]. Group 2 were those discharged between March-June 2014 and scheduled for routine 90 day follow up (n=196, 60 ± 16.15 years; 47% female). We hypothesized that earlier follow up would be associated with greater appointment adherence, projected to be at least 70%.

In Group 1, 55% (n=93) completed appointments in the Stroke TOC Clinic; 28% (n=48) did not show up for the appointment and 17% (n= 28) either cancelled or declined appointment. In Group 2, 50% (n=98) completed follow up appointment; 48% (n=94) no-showed, and 2% (n=4) either cancelled or declined appointment.

While show rates in Group 1 were higher than in Group 2, they did not reach projected estimates; however, fewer patients no-showed as compared to Group 2. Our study is ongoing, and evaluating other factors affecting, including patient geographic location, insurance status, and comorbid conditions, will allow for a better understanding of patient compliance.