Effectiveness of a Follow up System for Patients with Abnormal Pap Smear at Gynecology Section, Srinagarind Hospital

Abstract

Background and rational: Gynecology Out patient Section,  Srinagarind Hospital services  colposcopy and biopsy diagnosis for the abnormal Pap smear patients. From 2005-2007, there were averaged about 600 out patients/year.However, we found that some patients who already made the appointment of follow up but did not come to follow up after apartment .

Objectives: To assess the effectiveness of a follow up system  in patients with  abnormal Pap smear.

Design: Descriptive study

Material and method: Medical record charts of  541 outpatients who had abnormal Pap smears from 1 July 2006 to 30 June 2007  were reviewed.

Measurement: Percentage of the abnormal Pap smear patients who  lost to follow up.

Results: The incidence of lost follow up for further investigation  were 6.7% which one-fifth of the former study. We could contact only 4.1% of the patients. The reasons for lost follow up included: ; using right  insurance in right place 27.5%, going to the hospitals that  closed to their families 17.2%, busy 17.2%, financial problems 13.8%, traveling during coming the remind letter 13.8%, too long time to wait  6.9.%,  lost of the follow up letter 3.4%.

Conclusion: The study revealed that there was a small number of patients who lost follow up. . Most of them used  their right insurance in right place or wanted to the hospital close to their family.However there was 6.7% of patients did not realize that follow up system and  further investigation  was essential to prevent cancer. Therefore, the study shows that some changes should be made in the system to improve follow up compliance;such as  patient education , encouragement for patients to contact the hospital for the results if they do not get the letter, and continue assessment of the effectiveness of the follow up system for patients with abnormal Pap smear.

Keywords : Abnormal Pap smear, follow-up system