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Optimizing postoperative follow-up in pediatric surgery (OFIPS)

Tamara Gimon1, Osama Almosallam1, Steven Lopushinsky1

  • 1University of Calgary, Department of Surgery; Pediatric Surgery, Alberta Children's Hospital, 28 Oki Drive, Calgary, Alberta, Canada, T3B6A8.

Journal of Pediatric Surgery
|March 4, 2019
PubMed

Insights

Postoperative clinic follow-up for pediatric surgery patients often lacks clinical value, incurring substantial costs for families and healthcare systems. Optimizing follow-up strategies is crucial for improving care efficiency and patient outcomes.

Area of Science:

  • Pediatric Surgery
  • Healthcare Management
  • Clinical Outcomes Research

Background:

  • Postoperative clinic follow-up (POFU) is a standard component of pediatric surgical care.
  • The clinical value and cost-effectiveness of routine POFU in pediatric surgical patients are not well-defined.
  • Understanding factors influencing POFU attendance is essential for optimizing healthcare resource allocation.

Purpose of the Study:

  • To identify variables associated with POFU attendance in pediatric surgical patients.
  • To determine predictors of clinical value for POFU visits.
  • To estimate the costs associated with POFU for both families and the healthcare system.

Main Methods:

  • Retrospective analysis of POFU patterns for children undergoing eight common pediatric surgical procedures over one year.
  • Statistical analysis to identify variables associated with attendance, clinical value, and cost.
  • Driving distance to the hospital used as a proxy for family cost.

Main Results:

  • 58% of 633 pediatric surgical patients attended POFU.
  • Factors associated with attendance included specific procedures (orchidopexy, complicated appendicitis), proximity to the hospital, and surgeon presence.
  • Clinical value was found in 16.4% of visits, linked to specific procedures and complex cases.
  • Estimated costs were ~$125,000 for the healthcare system and ~$15,000 for families from non-essential follow-ups.

Conclusions:

  • Routine POFU for common pediatric surgical procedures may offer limited clinical benefit.
  • POFU incurs significant financial burdens on families and healthcare systems.
  • Further research is necessary to establish optimal, evidence-based follow-up protocols for pediatric surgical patients.
Abstract

Keywords:
Clinic valueCostsPediatric surgeryPerceived valuePostoperative follow-up

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