The Impact of the Affordable Care Act on Outpatient Spine Trauma Consult Follow-up

Canseco, José A.; Karamian, Brian A.; Patel, Parthik D.; Hilibrand, Alan S.; Rihn, Jeffrey A.; Kurd, Mark F.; Anderson, D. Greg; Kepler, Christopher K.; Vaccaro, Alexander R.; Schroeder, Gregory D.

doi:10.1097/bsd.0000000000001277

Cited by 1 publication

(4 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5,6,20 Existing literature approximates that 27 to 33% of orthopaedic patients miss their first postoperative visit and that 70% of patients will miss at least one appointment in the first 6 months. 1,2,8,13 By comparison, our study found that 6% of patients did not attend their first scheduled follow-up appointment, an additional 10% missed their second follow-up appointment, and a total of 15% did not attend one of their appointments. To address this, many clinics will overbook appointments to retain productivity in the setting of missed visits; however, there are increased opportunity costs to patients through prolonged queues in clinic and decreased patient satisfaction, which may further exacerbate future no-show rates.…”

Section: Discussionmentioning

confidence: 99%

“…Yet in our study, being Black or of African American descent increased the risk of missing appointments. Similar to the observations made by Canseco et al, 13 demographic factors such as race may be serving as a proxy for lower socioeconomic status and level of education. However, these are challenging to assess on presentation and even more so in rural groups.…”

Section: Demographicsmentioning

confidence: 99%

“…Missed appointments and noncompliance are challenging topics that prevent the surgeon from adequately addressing postoperative complications and have been associated with poorer outcomes including worse function, greater pain, strain on the patientphysician relationship, higher costs, and delays in recognition of complications such as surgical site infection or fracture nonunion. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Previous studies have examined factors associated with patients with orthopaedic trauma missing follow-up appointments at urban level 1 trauma centers with conflicting results regarding distance. 1,2 Influence of distance on attendance to follow-up visits in a more rural setting has yet to be investigated.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Factors Influencing Compliance to Follow-up Visits in Orthopaedic Surgery

Bender,

Jain,

Giron

et al. 2024

JAAOS Glob Res Rev

View full text Add to dashboard Cite

Background: Orthopaedic procedures require postoperative follow-up to maximize recovery. Missed appointments and noncompliance can result in complications and increased healthcare costs. This study investigates the relationship between patient postoperative visit attendance and the distance traveled to receive care. Materials and Methods: A retrospective review of all surgeries performed by a single orthopaedic surgeon in 2019 at level 1 trauma center in a midsized city serving a largely rural population was completed. We excluded patients who underwent another subsequent procedure. Distance to care and time traveled were determined by the patient's address and the clinic address using Google Maps Application Programming Interface. Other variables that may affect attendance at follow-up visits were also collected. Univariate and multivariate logistic regression was done with purposeful selection. Results: We identified 518 patients of whom 32 (6%) did not attend their first scheduled follow-up appointment. An additional 47 (10%) did not attend their second follow-up. In total, 79 patients (15%) did not attend one of their appointments. Younger age, male sex, Black or African American race, self-pay, Medicaid insurance, accident insurance, and increased distance were individual predictors of missing an appointment. In the final multivariate logistic regression model, male sex (OR 1.74), Black or African American race (OR 2.78), self-pay (OR 3.12), Medicaid (OR 3.05), and traveling more than 70 miles to clinic (OR 2.02) markedly predicted missing an appointment, while workers' compensation (OR 0.23) predicted attendance. Discussion: Several nonmodifiable patient factors predict patient noncompliance in attending orthopaedic postoperative visits. When patients are considered at high risk of being lost to follow-up, there may be an opportunity to implement interventions to improve follow-up rate and patient outcomes, minimize patient costs, and maximize profitability for the hospital.

show abstract