Examining emergency department utilization in the post-foregut surgery patient

Area of Science:

• Gastroenterology
• Surgical Oncology
• Health Services Research

Background:

• Minimally invasive foregut surgery necessitates understanding post-operative emergency department (ED) utilization.
• Evaluating ED visits' impact on healthcare costs is crucial for resource management.

Purpose of the Study:

• To analyze ED utilization patterns after minimally invasive foregut surgery.
• To assess the preventability and cost implications of these ED visits.
• To identify strategies for reducing unnecessary post-operative ED visits.

Main Methods:

• Retrospective review of patients undergoing foregut procedures (January 2018 - June 2019).
• Analysis of ED visits within 90 days post-surgery, categorized by timing (0-30 vs. 31-90 days) and time of day.
• Comparison of visit reasons, preventability, and costs between early and delayed visits.

Main Results:

• 20% of 458 patients had ED visits within 90 days; 64.1% were early (0-30 days).
• 60.9% of visits were surgery-related, 35.7% were preventable, and median cost was $970.
• Early visits were more surgery-related (72.9% vs. 39.4%), but preventability and cost did not differ significantly between early and delayed visits.

Conclusions:

• Emergency department visits are frequent after foregut surgery, posing a financial burden.
• A significant proportion of these visits are preventable and occur during regular clinic hours.
• Implementing strategies to enhance outpatient care can decrease unnecessary ED utilization.