Reduced Returns to ED With Post-Tonsillectomy and Adenoidectomy Chat Program: Outcomes and Costs

Area of Science:

• Pediatric Otolaryngology
• Health Informatics
• Patient Education

Background:

• Postoperative care for pediatric tonsillectomy often involves frequent patient questions and potential complications.
• Effective patient education and communication are crucial for reducing postoperative emergency department (ED) visits.
• Automated messaging systems offer a scalable solution for patient support.

Purpose of the Study:

• To evaluate the impact of a post-tonsillectomy chat program on emergency department (ED) visit rates.
• To compare ED visit causes between participating and non-participating patients.
• To analyze the cost-effectiveness of the chat program.

Main Methods:

• Retrospective chart review of 1059 pediatric tonsillectomy patients (children/caregiver dyads) enrolled in a texting program.
• Stratification of patients into participants (52.7%) and non-participants (47.3%).
• Analysis of ED visit rates, causes (communication lapse vs. expected symptoms), and cost-effectiveness.

Main Results:

• Non-participants were 9.12 times more likely to have postoperative ED visits due to communication lapses (p=0.047).
• Patients with public insurance showed lower participation rates.
• Estimated cost savings from avoided ED visits did not offset the chat program's operational expenses.

Conclusions:

• Automated messaging systems significantly reduce ED visits and readmissions for pediatric tonsillectomy patients.
• The reduction in ED visits was particularly notable for complications arising from communication failures.
• Despite reduced ED visits, the overall healthcare costs increased due to program expenses.