MedicalResearch: What are the main findings of the study?
Dr. Brooke: This study was designed to evaluate whether high-risk surgical patients who visit a primary care provider (PCP) during the early period following hospital discharge are less likely to be readmitted within 30-days. We examined this question by performing a retrospective cohort analysis of Medicare beneficiaries (2003-2010) who underwent a high risk surgery (open thoracic aortic aneurysm repair) as well as a control group of patients who underwent a lower risk surgical procedure (open ventral hernia repair), and then determining whether there was evidence of early PCP follow-up.
In risk-adjusted analyses, we found that early primary care provider-follow-up was associated with a significant lower likelihood of 30-day readmission for high-risk patients undergoing open thoracic aortic aneurysm repair, particularly if a post-operative complication had occurred. In comparison, early primary care provider follow-up did not have a significant effect on lowering readmissions in uncomplicated patients and those undergoing lower-risk operations such as ventral hernia repair.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Brooke: These findings suggest that improving coordination of care between the surgical team and patients outpatient PCPs may provide an opportunity to reduce 30-day readmissions for high-risk surgical patients. Patients who suffer post-operative complications or have other risk factors for readmission following complex surgery should be scheduled for early PCP follow-up at the time of hospital discharge.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Brooke: The findings of this study suggest that future research needs to focus more closely on the post-discharge care of surgical patients as a strategy for improving outcomes.