Healthcare utilization following minimally invasive apical prolapse repair in a large integrated healthcare system

Ha, Barbara; Gordon, Toya; Ramm, Olga

doi:10.1007/s00192-021-04884-x

Cited by 2 publications

(3 citation statements)

References 20 publications

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“…Increasing age and BMI, concomitant hysterectomy, and an abdominal approach to apical suspension were found to be associated with a decreased likelihood of ≥5 encounters. These findings are consistent with those reported in a study that identified predictors of high postoperative HRU after minimally invasive abdominal and vaginal apical prolapse repair 10 . Postoperative pain was a primary reason for the majority of HRU encounters in our cohort.…”

Section: Discussionsupporting

confidence: 93%

“…These findings are consistent with those reported in a study that identified predictors of high postoperative HRU after minimally invasive abdominal and vaginal apical prolapse repair. 10 Postoperative pain was a primary reason for the majority of HRU encounters in our cohort. A decreased likelihood of postoperative pain and pain-related encounters associated with increased age, increased BMI, concomitant hysterectomy, and abdominal route may explain the protective effect of these factors.…”

Section: Discussionmentioning

confidence: 88%

“…Exploratory multivariable logistic regression was conducted to identify factors associated with ≥1 and ≥5 HRU encounters within 6 weeks after surgery. Preselection of factors was based on current literature [8][9][10] and included the following: age, body mass index (BMI), preoperative teaching method, health care professional conducting visit (nurse or APP), number of days preoperatively when teaching was conducted, geographic residence (≤60 or >60 miles from hospital), diabetes, myocardial infarction, cerebrovascular disease, cancer, chronic pulmonary disease, route of surgery, concomitant posterior compartment procedure, concomitant midurethral sling, concomitant hysterectomy, and voiding trial results. Results of multivariable analyses were reported as odds ratios (ORs) with corresponding 95% confidence intervals (CIs).…”

Section: Methodsmentioning

confidence: 99%

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Healthcare Resource Utilization After Apical Prolapse Surgery in Women Who Received In-Office Versus Telephone-Only Preoperative Teaching

Lua

Roversi

Yao

et al. 2023

UROGC

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Importance Despite increasing use of telehealth, no studies have evaluated telehealth use for preoperative teaching and its impact on healthcare resource utilization (HRU) after gynecologic surgery. Objectives This study aimed to compare HRU after apical prolapse surgery in women receiving in-office versus telephone-only preoperative teaching and identify factors associated with postoperative HRU. Study Design A retrospective cohort study of women who underwent apical prolapse surgery from 2017 to 2020 at a tertiary referral center was conducted. Women were grouped based on the preoperative teaching type they received. Healthcare resource utilization was defined as a composite of patient-initiated calls, unscheduled outpatient visits, emergency department visits, and readmissions before the scheduled 6-week postoperative visit. Healthcare resource utilization was compared between in-office and telephone-only groups. Multivariable regression analysis was performed to identify factors associated with HRU. Results A total of 1,168 women underwent in-office teaching, and 181 had telephone-only teaching. Of the 1,349 women, 980 (72.6%) had ≥1 HRU encounter and 222 (16.5%) had ≥5 HRU encounters within 6 weeks after surgery. There was no difference between telephone and office groups for composite outcomes of ≥1 HRU (78.5% vs 71.7%, P = 0.06) and ≥5 HRU (13.3% vs 17.0%, P = 0.21) encounters. A failed voiding trial was associated with a 4.4-fold increased risk of ≥5 encounters. Increasing age and body mass index, concomitant hysterectomy, and abdominal route were associated with a decreased likelihood of ≥5 encounters. Conclusions Three of 4 women had at least 1 unanticipated HRU encounter within 6 weeks after apical prolapse surgery. Preoperative teaching type was not associated with postoperative HRU. Telephone visits may be considered as an alternative to in-office visits for preoperative teaching.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 88%