The effect of standardized discharge instructions after gastrostomy tube placement on postoperative hospital...

Area of Science:

• Pediatric Surgery
• Healthcare Management
• Patient Outcomes

Background:

• Gastrostomy tube (GT) placement is a frequent pediatric surgical procedure.
• High postoperative healthcare resource utilization is associated with GT placement.
• There is a need to optimize post-procedure care and reduce healthcare costs.

Purpose of the Study:

• To evaluate the impact of standardized discharge instructions (SDI) on postoperative healthcare utilization after pediatric GT placement.
• To determine if SDI can reduce emergency department visits, hospital readmissions, and other healthcare resource utilization.
• To assess the long-term effects of SDI on patient follow-up care.

Main Methods:

• Retrospective cohort study design.
• Comparison of patients undergoing GT placement before and after SDI protocol implementation (2014-2019).
• Statistical analyses included Chi-square, logistic regression, Cox proportional hazard, and Poisson regression models.

Main Results:

• 197 pediatric patients were analyzed (102 pre-SDI, 95 post-SDI).
• No significant difference in total 30-day postoperative hospital utilization events between groups (48.0% vs. 38.9%, p=0.25).
• SDI group showed significantly lower 30-day emergency department visits (8.4% vs. 19.6%, p=0.026) and office visits (11.6% vs. 25.5%, p=0.017).
• Non-SDI patients had higher odds of ED visits, office visits, and phone calls at 1-year post-discharge.

Conclusions:

• Standardized discharge instructions (SDI) following pediatric gastrostomy tube placement show potential to reduce specific aspects of postoperative healthcare utilization.
• SDI may decrease the need for unscheduled emergency department visits and follow-up office appointments.
• Further research can explore optimizing SDI to maximize benefits in pediatric surgical care.