Mariano E. Menendez|David Ring
Emergency Department Visits After Hand Surgery Are Common and Usually Related to Pain or Wound Issues
Massachusetts General Hospital|Massachusetts General Hospital
background payment models shift toward focus value reimbursement becomes increasingly tied quality patient experience minimizing unexpected acute health needs become priority policymakers clinical leaders despite recent emphasis emergency department ed visits quality measure surgery little known role ed early postoperative period hand surgery questionspurposes purpose study determine rates reasons factors associated ed visits within 30 days elective outpatient hand surgery methods using institutional database 2009 2013 assessed ed visit rates 2332 patients undergoing carpal tunnel trigger finger release medical records manually reviewed ascertain primary reason ed visit multivariable logistic regression modeling used identify factors independently associated ed use results total 67 patients 3 experienced least one ed visit within 30 days hand surgery carpal tunnel 3 trigger finger 3 visits 66 occurred within first 2 weeks surgery 31 led hospitalization common reasons ed visits pain 18 wound issues 16 unmarried medically infirm patients likely visit ed conclusions ed visits hand surgery common often related procedure potentially responsive quality improvement initiatives targeted efforts educate patients pain management wound care expected course recovery surgery together close postoperative contact eg routine phone calls facsimile correspondence email secure messaging may limit visits ed level evidence level iv prognostic study