An after-hours pediatric walk-in clinic for an entire urban community: Utilization and effectiveness of follow-up care

A retrospective record review was used to examine utilization of a pediatric walk-in clinic available to an entire urban community and to evaluate the effectiveness of follow-up care for a sample of the users of this facility who receive their regular pediatric care at a local comprehensive child health center. Results indicate that this walk-in facility is used extensively for the care of nonemergency conditions. The findings did not, however, support the generally accepted belief that a disproportionate number of Medicaid-supported and minority children overuse emergency type facilities. Utilization did not differ by race or medical care financing. Only 35.6% of the children who were advised to make a follow-up visit to the health center actually did so. White children complied significantly more often than black children (48.0% vs 15.8%). A larger percentage of patients for whom follow-up was optional (48.5%) than for whom follow-up was recommended (35.6%) made a return visit. Noncompliance with recommendations concerning follow-up care of adult users of emergency type facilities is a well recognized problem; the present study demonstrates a similar problem among children.