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Telephonic follow-up after day case pediatric surgery in an upper middle income country: A pilot study
Nirav Patel1,2, Jerome Loveland1,2,3, Juan Scribante1,2
1Department of Paediatric Surgery, Faculty of Health Sciences, School of Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Insights
Telephonic post-operative follow-up for day surgery patients is safe and effective. This approach offers significant cost and time savings for patients and the healthcare system, especially in areas with high unemployment.
Area of Science:
- Healthcare innovation
- Health services research
- Telemedicine applications
Background:
- High rates of child poverty in South Africa, with one-third of children in households without employed adults.
- Strained public health sector resources necessitate innovative solutions.
- Telemedicine presents a potential avenue for resource optimization in healthcare delivery.
Purpose of the Study:
- To evaluate the safety and benefits of telephonic post-operative follow-up for day case surgery patients.
- To assess patient and healthcare system resource savings through remote follow-up.
- To determine the feasibility of telephonic follow-up in a resource-limited setting.
Main Methods:
- Prospective descriptive study of patients undergoing day case surgery.
- Inclusion criteria: healthy patients >6 years old, English-speaking caregivers with smartphone access.
- Data collected on follow-up numbers, complications, need for in-person review, satisfaction, and cost/time savings.
Main Results:
- 38 telephonic follow-ups were conducted; 15.8% required in-person review due to complications or concern.
- All caregivers reported satisfaction with telephonic follow-up.
- R4452 (US $248.45) in transport costs saved; 18.4% of caregivers avoided paid leave.
Conclusions:
- Telephonic follow-up is a safe, acceptable, and cost-effective intervention for selected day surgery patients.
- Expanding such programs can lead to substantial savings for both patients and the healthcare system.
- Innovation in care delivery is crucial for accessible, affordable, and timely healthcare.
Background:
One third of South African children live in households with no employed adult. Telemedicine may save patients and the strained public health sector significant resources. We aimed to determine the safety and benefits of telephonic post-operative follow-up of patients who presented for day case surgery at CHBAH from 1 January-31 March 2023.
Methods:
A prospective descriptive study on patients undergoing day case surgery was performed. Healthy patients greater than 6 years old whose caregivers spoke English and had access to a smartphone were included. Data on the total number of telephonic follow-ups, operative complications, need for in person review, satisfaction with telephonic follow-up, and savings in transport costs and time by avoiding in person follow-up were collected.
Results:
A total of 38 telephonic follow-ups were performed. Six (15.8%) patients presented for in person review due to the detection of major complications (2, 5.3%), minor complications (2, 5.3%), and parental concern (2, 5.3%) during telephonic follow-up. All caregivers reported being satisfied with telephonic follow-up. Total savings in transport costs were R4452 (US $ 248.45). The majority of patients (29, 76.3%) had at least one unemployed parent. Seven caregivers (18.4%) avoided taking paid leave and 2 (5.3%) unpaid leave from work due to follow-up being performed telephonically.
Conclusions:
Innovation is necessary in order to expand access to safe, affordable, and timely care. In this selected group, telephonic follow-up was a safe, acceptable, and cost-effective intervention. The expansion of such a program has the potential for significant savings for patients and the healthcare system.
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