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Views of patients and physicians on follow-up visits: results from a cross-sectional study in Swiss primary care.

PRINCIPLES
Decision making on follow-up visits is of great importance to patient-physician interaction and healthcare economy. However, followup visits are a somewhat neglected topic in primary-care research, and patients' views are widely unknown. The aim was to assess the relation between the views of patients and those of physicians on follow-up visits.


METHODS
We performed a cross-sectional study in six general practices in a rural area of Berne, Switzerland. Separately recorded paired data from patients and physicians on the need for and timing of revisits were analysed for differences and agreement. The revisit ultimately scheduled by the patient and the physician at the end of the consultation after sharing views on revisits was compared with the initial statements.


RESULTS
A total of 250 patient-physician consultations were observed. More patients (25%) than physicians (11%) (difference 14%; 95% CI 7% to 20%) deemed a revisit unnecessary or proposed need-based revisits. Observed patient-physician overall agreement on the need or no-need of further visits was 81% (95% CI 76% to 86%). If both patients and physicians (n = 164) agreed on the need for a revisit, patients preferred slightly longer revisit intervals than did their physicians (5.9 days; 95% CI -2.6 to 14.4). The revisit interval recorded in the appointment calendar at the end of the consultation nearly always matched the patient's preferences.


CONCLUSION
In one fifth of all consultations, patients' views on revisits differ from those of their physicians, with patients choosing a more liberal involvement in follow-up visits. Actively involving patients in the process of revisit handling might have an influence on revisit frequencies. The impact of the shared revisit handling on patientrelevant outcome measures and healthcare economy needs further consideration..