Unplanned emergency department or urgent care visits after outpatient rotator cuff repair: potential for avoidance
With the cost of health care rising, the potential to avoid costs from an unplanned return to the emergency department (ED) or urgent care center (UC) after elective outpatient rotator cuff repair (RCR) has been discussed but not extensively assessed. Outpatient RCR procedures were queried in a clos...
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| Veröffentlicht in: | Journal of shoulder and elbow surgery 2018-06, Vol.27 (6), p.993-997 |
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| creator | Navarro, Ronald A. Lin, Charles C. Foroohar, Abtin Crain, Steven R. Hall, Michael P. |
| description | With the cost of health care rising, the potential to avoid costs from an unplanned return to the emergency department (ED) or urgent care center (UC) after elective outpatient rotator cuff repair (RCR) has been discussed but not extensively assessed.
Outpatient RCR procedures were queried in a closed health care system, and all unplanned ED and UC visits within 7 days of procedures were collected and compared with other typical outpatient orthopedic procedures (knee arthroscopy, carpal tunnel release, and anterior cruciate ligament reconstruction). Avoidable diagnoses (ADs) for the unplanned visits were defined in advance as visits for (1) constipation, (2) nausea or vomiting, (3) pain, and (4) urinary retention. Final tallies of all visits versus visits with ADs were compared.
From June 2015 to May 2016, 1306 outpatient RCRs were performed (729 male and 577 female patients; average age, 60 years). Of the patients, 90 returned for ED or UC visits (6.9%), with 34 for ADs (2.6%). Pain was the most common AD. However, when RCR was compared with other case types, ED or UC visits for urinary retention were significantly more common (P = .007), whereas there was no significant difference with the other ADs. The 1306 RCRs led to a greater proportion of ED or UC visits than the combined 5825 other cases studied (P |
| doi_str_mv | 10.1016/j.jse.2017.12.011 |
| format | Article |
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Outpatient RCR procedures were queried in a closed health care system, and all unplanned ED and UC visits within 7 days of procedures were collected and compared with other typical outpatient orthopedic procedures (knee arthroscopy, carpal tunnel release, and anterior cruciate ligament reconstruction). Avoidable diagnoses (ADs) for the unplanned visits were defined in advance as visits for (1) constipation, (2) nausea or vomiting, (3) pain, and (4) urinary retention. Final tallies of all visits versus visits with ADs were compared.
From June 2015 to May 2016, 1306 outpatient RCRs were performed (729 male and 577 female patients; average age, 60 years). Of the patients, 90 returned for ED or UC visits (6.9%), with 34 for ADs (2.6%). Pain was the most common AD. However, when RCR was compared with other case types, ED or UC visits for urinary retention were significantly more common (P = .007), whereas there was no significant difference with the other ADs. The 1306 RCRs led to a greater proportion of ED or UC visits than the combined 5825 other cases studied (P < .001).
Unplanned ED visits within 7 days of outpatient RCR are measurable and in many cases, such as ED or UC visits for pain, are avoidable. Visits for urinary retention are seen more commonly after RCR. Outpatient RCR led to more unplanned ED and UC visits than other common outpatient orthopedic surgical procedures.</description><identifier>ISSN: 1058-2746</identifier><identifier>EISSN: 1532-6500</identifier><identifier>DOI: 10.1016/j.jse.2017.12.011</identifier><identifier>PMID: 29361411</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ambulatory Care - utilization ; ambulatory surgery ; Ambulatory Surgical Procedures - adverse effects ; Anterior Cruciate Ligament Reconstruction - adverse effects ; Arthroscopy - adverse effects ; avoidable diagnoses ; Carpal Tunnel Syndrome - surgery ; Child ; Child, Preschool ; Constipation - etiology ; Costs and Cost Analysis ; Emergency Service, Hospital - utilization ; Female ; Humans ; Infant ; Infant, Newborn ; Knee Joint - surgery ; Male ; Middle Aged ; Nausea - etiology ; near-term surgical follow-up ; Pain, Postoperative - etiology ; Postoperative Complications - etiology ; return to ED ; Rotator Cuff Injuries - surgery ; Rotator cuff repair ; unplanned ED visit ; Urinary Retention - etiology ; Vomiting - etiology ; Young Adult</subject><ispartof>Journal of shoulder and elbow surgery, 2018-06, Vol.27 (6), p.993-997</ispartof><rights>2017 Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-4b75baab9e0c118b95d9d55bf5a3df5dc5034115a03762413925b647acc8214e3</citedby><cites>FETCH-LOGICAL-c353t-4b75baab9e0c118b95d9d55bf5a3df5dc5034115a03762413925b647acc8214e3</cites><orcidid>0000-0003-3767-9259</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jse.2017.12.011$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27911,27912,45982</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29361411$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Navarro, Ronald A.</creatorcontrib><creatorcontrib>Lin, Charles C.</creatorcontrib><creatorcontrib>Foroohar, Abtin</creatorcontrib><creatorcontrib>Crain, Steven R.</creatorcontrib><creatorcontrib>Hall, Michael P.</creatorcontrib><title>Unplanned emergency department or urgent care visits after outpatient rotator cuff repair: potential for avoidance</title><title>Journal of shoulder and elbow surgery</title><addtitle>J Shoulder Elbow Surg</addtitle><description>With the cost of health care rising, the potential to avoid costs from an unplanned return to the emergency department (ED) or urgent care center (UC) after elective outpatient rotator cuff repair (RCR) has been discussed but not extensively assessed.
Outpatient RCR procedures were queried in a closed health care system, and all unplanned ED and UC visits within 7 days of procedures were collected and compared with other typical outpatient orthopedic procedures (knee arthroscopy, carpal tunnel release, and anterior cruciate ligament reconstruction). Avoidable diagnoses (ADs) for the unplanned visits were defined in advance as visits for (1) constipation, (2) nausea or vomiting, (3) pain, and (4) urinary retention. Final tallies of all visits versus visits with ADs were compared.
From June 2015 to May 2016, 1306 outpatient RCRs were performed (729 male and 577 female patients; average age, 60 years). Of the patients, 90 returned for ED or UC visits (6.9%), with 34 for ADs (2.6%). Pain was the most common AD. However, when RCR was compared with other case types, ED or UC visits for urinary retention were significantly more common (P = .007), whereas there was no significant difference with the other ADs. The 1306 RCRs led to a greater proportion of ED or UC visits than the combined 5825 other cases studied (P < .001).
Unplanned ED visits within 7 days of outpatient RCR are measurable and in many cases, such as ED or UC visits for pain, are avoidable. Visits for urinary retention are seen more commonly after RCR. Outpatient RCR led to more unplanned ED and UC visits than other common outpatient orthopedic surgical procedures.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Ambulatory Care - utilization</subject><subject>ambulatory surgery</subject><subject>Ambulatory Surgical Procedures - adverse effects</subject><subject>Anterior Cruciate Ligament Reconstruction - adverse effects</subject><subject>Arthroscopy - adverse effects</subject><subject>avoidable diagnoses</subject><subject>Carpal Tunnel Syndrome - surgery</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Constipation - etiology</subject><subject>Costs and Cost Analysis</subject><subject>Emergency Service, Hospital - utilization</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Knee Joint - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nausea - etiology</subject><subject>near-term surgical follow-up</subject><subject>Pain, Postoperative - etiology</subject><subject>Postoperative Complications - etiology</subject><subject>return to ED</subject><subject>Rotator Cuff Injuries - surgery</subject><subject>Rotator cuff repair</subject><subject>unplanned ED visit</subject><subject>Urinary Retention - etiology</subject><subject>Vomiting - etiology</subject><subject>Young Adult</subject><issn>1058-2746</issn><issn>1532-6500</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtKxDAUhoMo3h_AjWTppjUnadqprmTwBoIbXYc0OZUM06Ym6YBvb4ZRl65yyH-B_yPkAlgJDOrrVbmKWHIGTQm8ZAB75Bik4EUtGdvPN5OLgjdVfUROYlwxxtqK8UNyxFtRQwVwTML7OK31OKKlOGD4wNF8UYuTDmnAMVEf6Lz9TdTogHTjokuR6j5hoH5Ok05uKwafdMpeM_c9DTnuwg2dfMqa02vaZ0lvvLN6NHhGDnq9jnj-856S94f7t-VT8fL6-Ly8eymMkCIVVdfITuuuRWYAFl0rbWul7Hqphe2lNZKJPEFqJpqaVyBaLru6arQxCw4VilNyteudgv-cMSY1uGhwneein6OCtmULWeVctsLOaoKPMWCvpuAGHb4UMLVFrVYqo1Zb1Aq4yqhz5vKnfu4GtH-JX7bZcLszYB65cRhUNBmWQesCmqSsd__UfwM_D5DN</recordid><startdate>201806</startdate><enddate>201806</enddate><creator>Navarro, Ronald A.</creator><creator>Lin, Charles C.</creator><creator>Foroohar, Abtin</creator><creator>Crain, Steven R.</creator><creator>Hall, Michael P.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3767-9259</orcidid></search><sort><creationdate>201806</creationdate><title>Unplanned emergency department or urgent care visits after outpatient rotator cuff repair: potential for avoidance</title><author>Navarro, Ronald A. ; Lin, Charles C. ; Foroohar, Abtin ; Crain, Steven R. ; Hall, Michael P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-4b75baab9e0c118b95d9d55bf5a3df5dc5034115a03762413925b647acc8214e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Ambulatory Care - utilization</topic><topic>ambulatory surgery</topic><topic>Ambulatory Surgical Procedures - adverse effects</topic><topic>Anterior Cruciate Ligament Reconstruction - adverse effects</topic><topic>Arthroscopy - adverse effects</topic><topic>avoidable diagnoses</topic><topic>Carpal Tunnel Syndrome - surgery</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Constipation - etiology</topic><topic>Costs and Cost Analysis</topic><topic>Emergency Service, Hospital - utilization</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Knee Joint - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nausea - etiology</topic><topic>near-term surgical follow-up</topic><topic>Pain, Postoperative - etiology</topic><topic>Postoperative Complications - etiology</topic><topic>return to ED</topic><topic>Rotator Cuff Injuries - surgery</topic><topic>Rotator cuff repair</topic><topic>unplanned ED visit</topic><topic>Urinary Retention - etiology</topic><topic>Vomiting - etiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Navarro, Ronald A.</creatorcontrib><creatorcontrib>Lin, Charles C.</creatorcontrib><creatorcontrib>Foroohar, Abtin</creatorcontrib><creatorcontrib>Crain, Steven R.</creatorcontrib><creatorcontrib>Hall, Michael P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of shoulder and elbow surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Navarro, Ronald A.</au><au>Lin, Charles C.</au><au>Foroohar, Abtin</au><au>Crain, Steven R.</au><au>Hall, Michael P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unplanned emergency department or urgent care visits after outpatient rotator cuff repair: potential for avoidance</atitle><jtitle>Journal of shoulder and elbow surgery</jtitle><addtitle>J Shoulder Elbow Surg</addtitle><date>2018-06</date><risdate>2018</risdate><volume>27</volume><issue>6</issue><spage>993</spage><epage>997</epage><pages>993-997</pages><issn>1058-2746</issn><eissn>1532-6500</eissn><abstract>With the cost of health care rising, the potential to avoid costs from an unplanned return to the emergency department (ED) or urgent care center (UC) after elective outpatient rotator cuff repair (RCR) has been discussed but not extensively assessed.
Outpatient RCR procedures were queried in a closed health care system, and all unplanned ED and UC visits within 7 days of procedures were collected and compared with other typical outpatient orthopedic procedures (knee arthroscopy, carpal tunnel release, and anterior cruciate ligament reconstruction). Avoidable diagnoses (ADs) for the unplanned visits were defined in advance as visits for (1) constipation, (2) nausea or vomiting, (3) pain, and (4) urinary retention. Final tallies of all visits versus visits with ADs were compared.
From June 2015 to May 2016, 1306 outpatient RCRs were performed (729 male and 577 female patients; average age, 60 years). Of the patients, 90 returned for ED or UC visits (6.9%), with 34 for ADs (2.6%). Pain was the most common AD. However, when RCR was compared with other case types, ED or UC visits for urinary retention were significantly more common (P = .007), whereas there was no significant difference with the other ADs. The 1306 RCRs led to a greater proportion of ED or UC visits than the combined 5825 other cases studied (P < .001).
Unplanned ED visits within 7 days of outpatient RCR are measurable and in many cases, such as ED or UC visits for pain, are avoidable. Visits for urinary retention are seen more commonly after RCR. Outpatient RCR led to more unplanned ED and UC visits than other common outpatient orthopedic surgical procedures.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29361411</pmid><doi>10.1016/j.jse.2017.12.011</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-3767-9259</orcidid></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adolescent Adult Aged Aged, 80 and over Ambulatory Care - utilization ambulatory surgery Ambulatory Surgical Procedures - adverse effects Anterior Cruciate Ligament Reconstruction - adverse effects Arthroscopy - adverse effects avoidable diagnoses Carpal Tunnel Syndrome - surgery Child Child, Preschool Constipation - etiology Costs and Cost Analysis Emergency Service, Hospital - utilization Female Humans Infant Infant, Newborn Knee Joint - surgery Male Middle Aged Nausea - etiology near-term surgical follow-up Pain, Postoperative - etiology Postoperative Complications - etiology return to ED Rotator Cuff Injuries - surgery Rotator cuff repair unplanned ED visit Urinary Retention - etiology Vomiting - etiology Young Adult |
| title | Unplanned emergency department or urgent care visits after outpatient rotator cuff repair: potential for avoidance |
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