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Outpatient hospital utilization after single event multi-level surgery in children with cerebral palsy
Kelly R Greve1,2, Amy F Bailes1,2, Nanhua Zhang3,4
1Motion Analysis Lab, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
Children with cerebral palsy (CP) undergoing single event multi-level surgery (SEMLS) had fewer therapy visits but more orthopaedic and radiology visits post-surgery. Non-ambulatory children saw more specialists after SEMLS.
Area of Science:
- Pediatric Orthopedics
- Rehabilitation Medicine
- Cerebral Palsy Research
Background:
- Single event multi-level surgery (SEMLS) is a complex intervention for children with cerebral palsy (CP).
- Understanding post-surgical healthcare utilization is crucial for optimizing care pathways.
- Ambulatory status significantly impacts the needs of children with CP.
Purpose of the Study:
- To analyze outpatient hospital utilization in children with CP after SEMLS.
- To compare healthcare utilization in the year before and after SEMLS.
- To identify factors influencing post-SEMLS care needs.
Main Methods:
- Retrospective cross-sectional study design.
- Utilized electronic medical record data for outpatient hospital visits.
- Included 30 children with CP (GMFCS Levels I-V, mean age 9.9 years).
Main Results:
- Non-ambulatory children with CP saw significantly more specialties post-SEMLS (p=0.001).
- Overall outpatient visits per specialty did not significantly change.
- Therapy visits decreased (p<0.001), while orthopaedic (p=0.001) and radiology (p=0.001) visits increased post-SEMLS.
Conclusions:
- Children with CP experience a shift in healthcare utilization post-SEMLS, with increased orthopaedic and radiology focus.
- Ambulatory status is a key determinant of post-surgical specialty care needs.
- Care planning for SEMLS in CP should consider surgical burden, immobilization, and ambulatory status.
Purpose:
This study aimed to examine outpatient hospital utilization (number of specialties seen and number of visits to each specialty) in the year after single event multi-level surgery (SEMLS) in children with cerebral palsy (CP), and to determine if utilization differs across the medical center in the year after compared to the year before SEMLS.
Methods:
This retrospective cross-sectional study used electronic medical record data of outpatient hospital utilization in children with CP who underwent SEMLS.
Results:
Thirty children with CP (Gross Motor Function Classification System Levels I-V, mean age of 9.9 years) were included. In the year after surgery, a significant difference (p = 0.001) was found for the number of specialties seen, with non-ambulatory children seeing more specialties than ambulatory children. No statistically significant difference was found between the number of outpatient visits to each specialty in the year after SEMLS. Compared to the year before SEMLS, fewer therapy visits occurred in the year after SEMLS (p < 0.001) but significantly more visits to orthopaedics (p = 0.001) and radiology (p = 0.001).
Conclusion:
Children with CP had fewer therapy visits but more orthopaedic and radiology visits the year after SEMLS. Nearly half of the children were non-ambulatory. Examination of care needs in children with CP undergoing SEMLS is justified with consideration of ambulatory status, surgical burden, and post-operative immobilization.
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