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Emergency Department Use after Outpatient Surgery Among Dually-Enrolled VA and Medicare Patients
- Source :
- Qual Manag Health Care
- Publication Year :
- 2019
-
Abstract
- BACKGROUND Emergency department (ED) use following outpatient surgery may be associated with a surgery-related patient safety problem. We characterized ED use within 7 days of general, urology, orthopedic, ear/nose/throat, and podiatry surgical procedures and assessed factors associated with these visits by specialty. METHODS We calculated the 2011-2013 postoperative ED visit rate for Veterans older than 65 years dually enrolled in the Veterans Health Administration (VA) and Medicare, examined diagnoses, and used logistic regression to model patient, procedure, and facility factors associated with ED care. RESULTS Among 63 279 outpatient surgical procedures, 2778 (4.4%) resulted in an ED visit within 7 days; 23% of these were to non-VA facilities. Rates varied from more than 5% for urology and ear/nose/throat, to less than 3% for orthopedic and podiatry specialties. Genitourinary symptoms and surgical complications were common diagnoses across specialties. No patient, procedure, or facility factors were associated with ED use for every specialty. CONCLUSIONS A small proportion of VA outpatient surgical procedures result in ED use. Notably, nearly one-fourth of the postoperative ED visits may be missed by the VA because they occur in non-VA facilities. ED visits for urinary issues or surgical complications may be preventable; however, factors associated with ED use vary by specialty, suggesting different approaches may be needed to improve outcomes.
- Subjects :
- Male
medicine.medical_specialty
Health (social science)
Leadership and Management
Outpatient surgery
Specialty
Medicare
Article
03 medical and health sciences
Patient safety
0302 clinical medicine
Postoperative Complications
Risk Factors
Throat
medicine
Humans
030212 general & internal medicine
Care Planning
Nose
Aged
Retrospective Studies
Aged, 80 and over
business.industry
030503 health policy & services
Health Policy
Podiatry
Emergency department
United States
United States Department of Veterans Affairs
medicine.anatomical_structure
Logistic Models
Ambulatory Surgical Procedures
Orthopedic surgery
Emergency medicine
Female
0305 other medical science
business
Emergency Service, Hospital
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Qual Manag Health Care
- Accession number :
- edsair.doi.dedup.....776961013da1f2fa6044d3090fba9097