1 Division of Orthopedic Surgery, Albany Medical College, Albany, NY, USA.
2 Director of Orthopedic Research, Division of Orthopedic Surgery, Albany Medical College, Albany, NY, USA.
Foot Ankle Int. 2019 Feb;40(2):218-223. doi: 10.1177/1071100718804178. Epub 2018 Oct 25.
: The Centers for Medicare and Medicaid services (CMS) have implemented initiatives to improve postdischarge care and reduce unnecessary readmissions. Readmissions within 30 days are frequent and represent an economic burden on both patients and the healthcare system. The aim of this study was to evaluate the frequency and causes for urgent care visits within 30 days of discharge after ankle open reduction and internal fixation (ORIF) and determine factors correlated with such visits.
: This was a retrospective analysis of prospectively collected data. All patients who underwent ankle ORIF at our institution between July 1, 2016, and June 30, 2017, were included. Patients were identified using Current Procedural Terminology (CPT) codes for ankle ORIF. Patients' demographics including age, sex, race, body mass index, occupation, insurance payer, and comorbidities were documented.
: Thirty-five patients (10.51%) had urgent care visits within 30 days of discharge. Patients presented at a mean of 11.8 days after the day of surgery. Sixteen patients (45.71%) had cast/splint-related issues, 7 (20%) presented with pain, and 7 (20%) with increased operative site drainage. Univariate analysis demonstrated a statistically significant association between postoperative urgent care visits and patients with diabetes ( P = .03) or underlying psychiatric disorders ( P = .03).
: In this population study of patients undergoing ankle fracture surgery, we found that the rate of urgent care visits within 30 days of discharge exceeded the rate of inpatient readmission. Additionally, patients with diabetes and psychiatric disorders were significantly more likely to present to an urgent care facility postoperatively, potentially accounting for increased expenditures of the healthcare system.
: Level III, comparative series.
医疗保险和医疗补助服务中心（CMS）已经采取措施改善出院后的护理并减少不必要的再入院。30 天内再入院的情况很常见，这给患者和医疗保健系统都带来了经济负担。本研究的目的是评估踝关节切开复位内固定（ORIF）后 30 天内出院后紧急就诊的频率和原因，并确定与这些就诊相关的因素。
这是一项前瞻性收集数据的回顾性分析。所有在我院接受踝关节 ORIF 的患者均纳入本研究，时间为 2016 年 7 月 1 日至 2017 年 6 月 30 日。使用踝关节 ORIF 的当前程序术语（CPT）代码识别患者。记录患者的人口统计学资料，包括年龄、性别、种族、体重指数、职业、保险支付者和合并症。
35 例（10.51%）患者在出院后 30 天内进行了紧急就诊。患者在手术后平均第 11.8 天就诊。16 例（45.71%）患者出现了石膏/夹板相关问题，7 例（20%）患者出现疼痛，7 例（20%）患者出现手术部位引流增加。单因素分析显示，术后紧急就诊与患有糖尿病（P=0.03）或潜在精神疾病（P=0.03）的患者之间存在统计学显著关联。
在这项对接受踝关节骨折手术的患者进行的人群研究中，我们发现出院后 30 天内紧急就诊的比例超过了住院再入院的比例。此外，患有糖尿病和精神疾病的患者术后更有可能到急诊就诊，这可能导致医疗保健系统支出增加。
III 级，比较系列。
