“Are we there yet?”- factors affecting postoperative follow-up after general surgery procedures

Harkey, Kristen; Kaiser, Nicole; Inman, Michael; Reinke, Caroline E.

doi:10.1016/j.amjsurg.2018.09.016

Cited by 10 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The time savings associated with virtual visits is one potential avenue to decrease disparities in access to care, as patients with transportation challenges, dif-ficulty getting time off of work, or need for childcare may realize greater benefits. 19 However, there was no difference in percentage of patients completing a postdischarge appointment, suggesting that factors other than travel time likely affect patient decisions to complete recommended follow-up care. Patients and clinicians should be reassured that the critical visit portion, time together discussing medical needs, is preserved.…”

Section: Discussionmentioning

confidence: 94%

“…Virtual visits eliminated travel time and significantly decreased wait time for postdischarge appointments but did not decrease the amount of time patients were able to spend with the surgery team member. The time savings associated with virtual visits is one potential avenue to decrease disparities in access to care, as patients with transportation challenges, difficulty getting time off of work, or need for childcare may realize greater benefits . However, there was no difference in percentage of patients completing a postdischarge appointment, suggesting that factors other than travel time likely affect patient decisions to complete recommended follow-up care.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Postdischarge Virtual Visits for Low-risk Surgeries

et al. 2021

Self Cite

View full text Add to dashboard Cite

video-based virtual visits are a growing aspect of surgical care and have dramatically increased in the setting of the coronavirus disease 2019 (COVID-19) pandemic.OBJECTIVE To evaluate the outcomes of all-cause 30-day hospital encounter proportion among patients who have a postdischarge video-based virtual visit follow-up compared with in-person follow-up.DESIGN, SETTING, AND PARTICIPANTS Randomized, active, controlled noninferiority trial in an urban setting, including patients from a small community hospital and a large, tertiary care hospital. Patients who underwent minimally invasive appendectomy or cholecystectomy by a group of surgeons who cover emergency general surgery at these 2 hospitals were included. Patients undergoing elective and nonelective procedures were included.INTERVENTIONS Patients were randomized in a 2:1 fashion to video-based virtual visit or in-person visit. MAIN OUTCOMES AND MEASURESThe primary outcome is the percentage of patients with 30-day hospital encounter, and we hypothesized that there would not be a significant increase in the 30-day hospital encounter proportion for patients who receive video-based virtual postdischarge care compared with patients who receive standard (in-person) care. Hospital encounter includes emergency department visit, observation, or inpatient admission.RESULTS A total of 1645 patients were screened; 289 patients were randomized to the virtual group and 143 to the in-person group. Fifty-three patients crossed over to the in-person follow-up group. The percentage of patients who had a hospital encounter was noninferior for virtual visits (12.8% vs 13.3% for in-person, Δ 0.5% with 1-sided 95% CI, −ϱ to 5.2%). The amount of time patients spent with the clinician (mean of 8.4 minutes virtual vs 7.8 minutes in-person; P = .30) was not different, but the median overall postoperative visit time was 27.5 minutes shorter (95% CI, −33.5 to −24.0). CONCLUSIONS AND RELEVANCEPostdischarge video-based virtual visits did not increase hospital encounter proportions and provided shorter overall time commitment but equal time with the surgical team member. This information will help surgeons and patients feel more confident in using video-based virtual visits.

show abstract

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Postdischarge Virtual Visits for Low-risk Surgeries

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…We therefore rejected the hypothesis that longer travel distances lead to poorer adherence to follow-up recommendations. A study 14 investigating barriers to follow-up after general surgery procedures in people found that increased travel time was associated with a reduced likelihood of adhering to postoperative follow-up recommendations. The lack of association between travel distance and follow-up adherence in our study could be explained by the fact that owners were already willing to travel for the index treatment at our hospital over other more local specialty clinics, and owners who were willing to travel to our facility were not any more averse to returning for follow-up visits.…”

Section: Discussionmentioning

confidence: 99%

Nonadherence to follow-up recommendations is common for dogs and cats undergoing orthopedic surgery

Moya¹,

Reppenhagen²,

Kim³

2022

javma

View full text Add to dashboard Cite

OBJECTIVE To evaluate owner adherence to recommendations for follow-up examination of dogs and cats following orthopedic procedures and identify factors associated with adherence versus nonadherence. SAMPLE Medical records of 485 dogs and cats that underwent orthopedic surgery. PROCEDURES Cases were categorized as urgent or elective. Information obtained from the medical records consisted of species, age, body weight, proximity to the hospital, procedure cost, recommendations for coaptation, use of financial aid, and number of owners. Cases were considered adherent to follow-up recommendations if, at the latest visit or communication, no further visits were recommended. Cases were considered nonadherent if owners did not return for recommended follow-up visits. RESULTS Overall adherence to follow-up recommendations was 65.8% (319/485). Elective cases were 1.6 times as likely to be adherent to follow-up recommendations as were urgent cases, dog cases were 2.4 times as likely to be adherent as were cat cases, and cases with multiple owners listed were 2.1 times as likely to be adherent as were cases with 1 owner listed. Distance from the hospital had a statistically significant association with adherence, but the effect was not clinically important. Age, weight, coaptation, procedure cost, and use of financial aid were not significantly associated with adherence. CONCLUSIONS AND CLINICAL RELEVANCE The percentage of dogs and cats lost to follow-up following orthopedic surgery at an academic veterinary teaching hospital was substantial (166/485 [34.2%]). Efforts to improve follow-up adherence are especially indicated for animals undergoing urgent procedures, animals with single owners, and cats.

show abstract

“…Follow-up care reinforces positive behaviour and mitigates issues at the earliest. [7] There is a growing demand for convenient healthcare access, including affordable follow-up appointments. This raises the question if follow-up is necessarily a physical encounter at the health care centre and if a more cost-effective telemedicine platform can substitute it.…”

Section: Discussionmentioning

confidence: 99%

“…The post-discharge follow-up makes for an ideal time to review these results together. [7] This can be streamlined by advising the speci c cohort of patients with pending reports to follow-up at a recommended time as per the availability of their reports. However, with the advent of telemedicine, it is certainly possible to trace and review reports online and convey the same to the parents.…”

Section: Discussionmentioning

confidence: 99%

Determining the Clinical Value of Routine Post-operative follow-up in Common Paediatric Surgical Conditions: Prospective Observational Study

Menon

Pathak

Nayak

et al. 2022

Preprint

View full text Add to dashboard Cite

BACKGROUND: The traditional postoperative visit consists of an in-person hospital visit at a predetermined date requiring investment of time and resources. This study aims to determine , clinical value of routine post-operative physical follow-up for common paediatric surgery conditions, identifying factors determining the need and estimating the cost of follow-up. METHODOLOGY: Data of 226 patients admitted for routine paediatric surgical procedures were collected. The postoperative period was documented in detail and interventions done either physically or telephonically at follow-up were used as a proxy measure of clinical value. RESULTS: Out of 226 patients, 64.6% followed up physically and 35.4%, telephonically. Maximum patients with post-operative complications belonged to laparotomy group (22.2%) followed by complicated appendicitis (15.6%). Thirty (13.3%) patients required clinical intervention at follow-up. Patients with requirements of clinical intervention were observed to follow-up earlier than routine follow-up date, either by telemedicine or physical follow-up. CONCLUSION: Patients undergoing simpler procedures have lesser complications translating to fewer clinic visits whereas those undergoing procedures such as appendectomy and laparotomy require a physical follow-up since they are more susceptible to develop complications requiring interventions. By selecting patients for physical visit we can potentially eliminate unnecessary postoperative visits. Type of study: Prospective Observational Study Level of evidence: Level III

show abstract

“Are we there yet?”- factors affecting postoperative follow-up after general surgery procedures

Cited by 10 publications

References 14 publications

Postdischarge Virtual Visits for Low-risk Surgeries

Postdischarge Virtual Visits for Low-risk Surgeries

Nonadherence to follow-up recommendations is common for dogs and cats undergoing orthopedic surgery

Determining the Clinical Value of Routine Post-operative follow-up in Common Paediatric Surgical Conditions: Prospective Observational Study

Contact Info

Product

Resources

About