Emergency department utilization of case-managed patients following benign gynecologic surgery

Case management has been shown to reduce the amount of unnecessary emergency department visits among Medicaid or uninsured patients. This study aims to determine whether case management is associated with decreased unnecessary emergency department visits among benign gynecology surgical patients in the first 30 days following surgery.

Out of 875 patients, there were a total of 58 return visits to the emergency department within 30 days and only 6 readmissions. Twenty-four emergency department visits occurred in the case-managed group, and thirty-eight emergency department visits occurred in the non-case-managed group. The two factors that were statistically significant for increase odds of return to the emergency department were the type of surgery (inpatient versus outpatient) and case management. The odds for returning to the emergency department for those not receiving case management was found to be 4.53 to that of the case-managed group when controlling for BMI, age, marital status, and type of surgery.

In an effort to reduce healthcare costs, case management is a promising intervention to help postoperative patients manage their care while minimizing emergency department visits.