Southern California Kaiser Permanente Medical Group, Woodland Hills, CA, USA.
Am Surg. 2020 Oct;86(10):1373-1378. doi: 10.1177/0003134820964463. Epub 2020 Oct 25.
Unplanned returns after ambulatory surgery pose a burden to patients and health care providers alike. We hypothesized that a postoperative phone call by a physician would decrease avoidable returns to urgent care (UC) or the emergency department (ED) in the week after anorectal (AR), laparoscopic cholecystectomy (LC), inguinal hernia repair (IHR), and umbilical hernia repair (UHR) operations. A retrospective analysis from 1/2011 to 12/2015 across 14 Kaiser hospitals was conducted to determine baseline UC/ED return rates of patients pre-call. Between 10/2017 and 06/2019, physicians placed phone calls to patients within postoperative days (PODs) 1-4. The cohorts were compared using chi-squared analysis with significance determined at < .05. In total, 276 patients received a call, with the majority placed on PODs 1-3. There were no statistically significant differences in return rates between the pre- and post-call groups. All of the AR, 50.0% of LC, 66.7% of IHR, and 50.0% of UHR patients returned prior to phone call placement. Our data indicate that a physician phone call does not help in decreasing UC/ED returns. However, it is noteworthy that many of the returns occurred pre-call placement. Future directions should be aimed at placing earlier postoperative phone calls.
非计划性门诊手术后返回给患者和医疗服务提供者带来了负担。我们假设,在肛门直肠(AR)、腹腔镜胆囊切除术(LC)、腹股沟疝修补术(IHR)和脐疝修补术(UHR)手术后,医生打电话给患者,会降低术后一周内去紧急护理(UC)或急诊部(ED)的非必要返回率。对 2011 年 1 月至 2015 年 12 月期间的 14 家 Kaiser 医院进行了回顾性分析,以确定电话咨询前 UC/ED 患者的基线返回率。在 2017 年 10 月至 2019 年 6 月期间,医生在术后第 1-4 天(POD)给患者打电话。使用卡方分析比较队列,显著性水平确定为 <.05。共有 276 名患者接受了电话咨询,其中大多数是在 POD 1-3 时进行的。在电话咨询前和后两组之间,返回率没有统计学上的显著差异。所有 AR、50.0%的 LC、66.7%的 IHR 和 50.0%的 UHR 患者在电话咨询前已经返回。我们的数据表明,医生的电话咨询并不能帮助减少 UC/ED 的返回。然而,值得注意的是,许多返回发生在电话咨询前。未来的方向应该是尽早进行术后电话咨询。