Navigating Readmission Risks: The Impact of Post-Hospitalization Care in Emergency General Surgery
Unveiling the Crucial Role of Primary Care Follow-Up in Reducing 30-Day Readmission Rates
Introduction
As an acute care surgeon deeply invested in achieving optimal patient outcomes, I find it crucial to explore and understand the impact of post-hospitalization care on readmission rates. The study in focus, "Primary Care Physician Follow-Up and 30-Day Readmission After Emergency General Surgery Admissions1," delves into a critical aspect of patient care—evaluating the association between primary care follow-up and readmission rates in emergency general surgery (EGS) cases.
Understanding the Study
This cohort study, conducted between 2016 and 2018, involved 345,360 Medicare beneficiaries admitted for EGS conditions. The primary focus was assessing whether follow-up visits with a primary care physician (PCP) within 30 days after discharge affected the likelihood of 30-day readmission. The findings revealed a compelling association: patients who had PCP follow-up experienced a 67% reduced risk of readmission compared to those without such follow-up. This relationship held true across patients receiving both operative and nonoperative treatments during their index admission.
Implications for Surgeons
For surgeons specializing in emergency general care, this study offers significant insights. It highlights the critical role of post-discharge care in mitigating readmission risks. Notably, the study underscores the universal benefit of PCP follow-up, regardless of the treatment type (operative or nonoperative). Surgical postoperative visits did not alter the association between PCP follow-up and reduced readmission rates, emphasizing the standalone impact of primary care coordination.
Unveiling Disparities and Challenges
The study also uncovers disparities in PCP follow-up, revealing lower rates among
Black patients
Those with dual Medicare-Medicaid eligibility
Individuals with multiple comorbidities
These findings signal systemic challenges that hinder access to post-hospitalization primary care, necessitating a deeper examination of healthcare access and delivery strategies.
Conclusion: A Shift Towards Comprehensive Care
In summary, this research presents a compelling case for the pivotal role of PCP follow-up in post-EGS care, elucidating its potential to significantly lower readmission rates.
As acute care surgeons, embracing a holistic approach encompassing seamless transitions from inpatient to outpatient care could be a key strategy in achieving optimal outcomes and improving patient well-being after emergency surgeries.
Moneme AN, Wirtalla CJ, Roberts SE, Keele LJ, Kelz RR. Primary Care Physician Follow-Up and 30-Day Readmission After Emergency General Surgery Admissions. JAMA Surg. 2023;158(12):1293–1301. doi:10.1001/jamasurg.2023.4534