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Published on: January 7, 2019
Understanding why caregivers call after ambulatory pediatric urologic surgery
Edward Chang1, Lauren Nicassio1, Julie Whalen2
1University of Washington School of Medicine and the Department of Pediatric Urology at Seattle Children's Hospital, Seattle, Washington, USA.
Insights
Nearly one-third of families call after pediatric urologic surgery. Factors like distance and language influence calls, while specific surgeries increase call likelihood, highlighting social determinants of health in postoperative care.
Area of Science:
- Pediatric Urology
- Health Services Research
- Social Determinants of Health
Background:
- Postoperative triage phone calls are common after pediatric ambulatory urologic surgery.
- Understanding factors influencing these calls is crucial for optimizing patient care and resource allocation.
Purpose of the Study:
- To identify factors associated with postoperative triage phone calls from caregivers after pediatric ambulatory urologic surgery.
- To investigate the role of social determinants of health in postoperative call rates.
Main Methods:
- Retrospective cohort study of patients undergoing ambulatory urologic surgery from July 2014 to January 2020.
- Analysis of postoperative phone calls within 30 days of surgery.
- Univariable and multivariable logistic regression to identify associated factors.
Main Results:
- 28% of families (460/1618) called post-surgery, with an average of 1.5 calls per family.
- Factors associated with decreased calls included greater distance, non-English primary language, and Native American/Alaskan Native ethnicity.
- Factors associated with increased calls included commercial insurance and specific procedures (penile surgery, hypospadias repair).
Conclusions:
- Approximately one-third of families contact triage lines post-ambulatory urologic surgery.
- Children undergoing penile surgery are significantly more likely to prompt a postoperative call.
- Social determinants of health appear to influence postoperative call rates, with underserved populations less likely to call.
Introduction:
To uncover factors associated with an increased likelihood of a postoperative triage phone call from caregivers after pediatric ambulatory urologic surgery with a focus on social determinants of health.
Materials And Methods:
This was a retrospective cohort study from July 2014-January 2020. Patients undergoing ambulatory urologic surgery by three different pediatric urologists were included. The primary outcome was the number of patient families that called within 30 days after surgery. Univariable tests and multivariable logistic regression analysis were used to identify factors associated with the increased likelihood of a postoperative phone call.
Results:
The families of 460 patients out of 1618 patients called at least once within 30 days of surgery (28%). There were 665 total calls, an average number of 1.5 (SD+/-0.8) phone calls per family. Families who live further away (OR 0.66, 95%CI 0.46-0.93), who do not speak English as a primary language (OR 0.61, 95%CI 0.38-1.00), and who were Native American/Alaskan Native (OR 0.33, 95%CI 0.11-0.99) were less likely to call after surgery. Those with commercial insurance (OR 1.42, 95%CI 1.09-1.85), recovering from non-hypospadias penile surgery (OR 3.20, 95%CI 2.46-4.32), or from hypospadias repair (OR 5.14, 95%CI 3.28-8.18) were more likely to call after surgery.
Conclusions:
Nearly 1 in 3 families call the hospital triage line after ambulatory urologic surgery with postoperative concerns. Families with children who undergo penile surgery are 3-5 times more likely to call after surgery. Social determinants of health may have a role in postoperative phone call rates as medically underserved patients are less likely to call.
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