HealthDay News — For surgical patients at high risk of readmission, especially those with surgical complications, early primary-care provider follow-up reduces the rate of readmission, according to researchers.

“Follow-up with a primary care provider in addition to the surgical team is routinely recommended to patients discharged after major surgery despite no clear evidence that it improves outcomes,” Benjamin S. Brooke, MD, PhD, from the University of Utah, and colleagues reported in JAMA Surgery.

To examine whether PCP follow-up is associated with lower 30-day readmission rates after procedures known to have high and low risk of readmission (open thoracic aortic aneurysm [TAA] repair and ventral hernia repair [VHR], respectively), investigators compared readmission rates for patients who were and were not seen by a PCP (n=12,679), and Medicare beneficiaries (n=52,807) who were discharged home after open TAA repair and VHR between 2003 and 2010.


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The risk of readmission was significantly reduced with early PCP follow-up among open TAA repair patients (35% without follow-up compared with 20% with follow-up; P<0.001).

For patients whose hospital course was uncomplicated, PCP follow-up had no significant impact on readmission (19% with follow-up versus 22% without follow-up; P=0.31). Regardless of complications, early PCP follow-up had no impact on the risk of readmission after VHR.

“Follow-up with a PCP after high-risk surgery (eg, open TAA repair), especially among patients with complications, is associated with a lower risk of hospital readmission,” the researchers wrote. “Identifying high-risk surgical patients who will benefit from PCP integration during care transitions may offer a low-cost solution toward limiting readmissions.”

References

  1. Brooke B et al. JAMA Surgery. 2014; doi: 10.1001/jamasurg.2014.157