Emergency Department Utilisation after Elective Hand Surgery and Distal Radius Fracture Fixation Is Associated with...

Area of Science:

• Health Services Research
• Socioeconomic Determinants of Health
• Orthopedic Surgery Outcomes

Background:

• Emergency department (ED) utilization post-surgery is a significant concern for healthcare systems.
• Identifying risk factors for postoperative ED visits is crucial for resource allocation and patient care improvement.
• Socioeconomic status, specifically mean area income, may influence access to care and subsequent ED utilization.

Purpose of the Study:

• To investigate the association between mean area income and emergency department (ED) utilization following hand and upper-extremity surgery.
• To determine if lower socioeconomic status predicts a higher likelihood of postoperative ED visits.
• To inform strategies for reducing preventable ED utilization by understanding income-related disparities.

Main Methods:

• Retrospective cohort study utilizing a national administrative claims database.
• Inclusion of patients undergoing common upper-extremity surgeries, including elective procedures and distal radius fracture fixation.
• Multivariable logistic regression analysis to assess the relationship between mean area income and ED visit odds at 7 and 30 days postoperatively.

Main Results:

• A cohort of 2,123,692 patients was analyzed.
• Patients from areas with lower mean incomes (< $65,000) exhibited a higher incidence of ED utilization within 7 and 30 days post-surgery compared to those from higher-income areas (≥ $65,000).
• Each $10,000 increase in mean area income correlated with a 5%-6% decrease in the odds of an ED visit at both postoperative time points.

Conclusions:

• Mean area income demonstrates a significant, inverse relationship with postoperative ED utilization after both elective upper extremity and distal radius fracture surgeries.
• Mean area income serves as a valuable contextual factor for identifying patients at higher risk of requiring postoperative ED care.
• Targeted interventions and resource deployment can be guided by socioeconomic data to mitigate disparities in surgical care outcomes.