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Utility of Postoperative Phone Calls in Reducing Unplanned Health Care Utilization
Kurt Panganiban1, Meridiana Mendez1, Amy Taylor1
1Division of Urology, Seattle Children's Hospital, Seattle, Washington.
Insights
Routine postoperative phone calls after pediatric urology surgery did not reduce healthcare use. However, calls may increase parent-initiated calls, especially in less disadvantaged areas, suggesting a need to define expectations for postoperative contact.
Area of Science:
- Pediatric Urology
- Health Services Research
Background:
- Postoperative phone calls aim to proactively identify patient concerns after surgery.
- Understanding the impact of these calls on healthcare utilization is crucial for optimizing patient care.
Purpose of the Study:
- To determine if postoperative phone calls after elective outpatient pediatric urology surgery influence postoperative healthcare utilization.
- To explore the association between completed calls and parent-initiated calls or emergency department visits.
Main Methods:
- Retrospective cross-sectional study of patients undergoing elective outpatient pediatric urologic surgery (2019-2021).
- Data abstracted included demographics, call completion, parent-initiated calls, and emergency department visits within 30 days.
- Comparison of healthcare utilization between patients with and without completed postoperative calls.
Main Results:
- 38.6% of 1494 patients had completed postoperative calls; these were more common in disadvantaged areas.
- No significant difference in overall emergency care visits (3.6% vs. 4.0%) or parent-initiated calls (31.7% vs. 31.3%) between groups.
- In less disadvantaged areas, completed calls were associated with a higher likelihood of parent-initiated calls (47.8% vs. 33.6%).
Conclusions:
- Routine postoperative phone calls within 72 hours are not linked to reduced overall postoperative healthcare utilization.
- Completed calls may increase parent-initiated calls to the clinic, particularly in less disadvantaged populations.
- Establishing clear patient and provider expectations for postoperative contact could enhance the utility of these calls.
Introduction:
Postoperative phone calls ideally proactively identify concerns. This study aimed to determine whether postoperative phone calls after elective outpatient pediatric urology surgery were associated with differences in postoperative healthcare utilization.
Methods:
This retrospective cross-sectional study included patients undergoing elective outpatient pediatric urologic surgery in selected months of 2019-2021. Data were abstracted on patient demographics, postoperative call completion, number and timing of parent-initiated calls within 30 d, concerns for parent-initiated calls, and timing and indication for emergency department visits within 30 d. Patients with and without completed postoperative calls were compared.
Results:
Of 1494 patients, 416 (38.6%) had completed postoperative phone calls; 1078 (61.4%) did not. Calls were more likely to be completed in more disadvantaged areas (Area Deprivation Index deciles 9-10; odds ratio [OR] = 3.87, 95% confidence interval [CI]: 2.70-5.54, P < 0.0001). Overall, the proportions of patients seeking emergency care within 30 d (3.6% versus 4.0%, OR = 0.90, 95% CI: 0.49-1.64, P = 0.73) and with parent-initiated phone calls (31.7% versus 31.3%, OR = 1.02, 95% CI: 0.80-1.20, P = 0.86) were similar in patients with and without postop calls completed. For children in less disadvantaged areas (Area Deprivation Index decile 1-2), the likelihood of a parent-initiated call was higher when postop calls were completed (47.8% versus 33.6%, OR = 1.79, 95% CI: 1.15-2.79, P = 0.01).
Conclusions:
Routine postoperative phone calls within 72 h of outpatient pediatric urologic surgery are not associated with decreased overall postoperative health care utilization, and in some cases are associated with an increase in calls to clinic. Defining patient and provider expectations for postoperative contact may make postoperative calls more useful.
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