TY - JOUR
T1 - Impact of Surgical Wait Time to Hysterectomy for Benign Gynecologic Disease
AU - Traylor, Jessica
AU - Koelper, Nathanael
AU - Kim, Sun Woo
AU - Sammel, Mary D.
AU - Andy, Uduak U.
N1 - Publisher Copyright:
© 2020 AAGL
PY - 2021/5
Y1 - 2021/5
N2 - Study Objective: To determine the impact of surgical wait time on healthcare use and surgical outcomes for patients undergoing hysterectomy for benign gynecologic indications. Design: Retrospective cohort study. Setting: Urban, academic tertiary care center. Patients: Patients who underwent hysterectomy for benign disease between 2012 and 2018. Interventions: None. Measurements and Main Results: Patients were categorized into 2 groups, dichotomized by surgical wait times >30 days or ≤30 days. Healthcare use was measured by the number of discrete patient interactions with the healthcare system through phone calls, secure electronic messaging, and office and emergency room visits. Univariate and multivariable logistic regression models were performed to assess the association between surgical wait time and healthcare use and perioperative outcomes while controlling for confounders. A total of 277 patients were included in our analysis: 106 (38.3%) had surgical wait times >30 days (median 47 days, range 24–68 days), and 171 (67.1%) had surgical wait times ≤30 days (median 19 days; range 12–26 days). The groups did not differ by age, insurance status, substance use, or comorbid conditions. Patients in the group with surgical wait times >30 days were more likely to have increased healthcare use (69 of 106, 65% vs 43 of 171, 25%; odds ratio 5.55; 95% confidence interval, 3.27–9.41). There were no differences in intraoperative complications (9 of 106, 8% vs 19 of 171, 11%; p =.482) or postoperative complications (28 of 106, 26% vs 32 of 171, 19%; p =.13) between the groups; however, after controlling for potential confounders, patients with surgical wait times >30 days were 3.22 times more likely to be readmitted than patients with surgical wait times ≤30 days (95% confidence interval, 1.27–8.19). Conclusion: A surgical wait time >30 days in patients undergoing a hysterectomy for benign disease is associated with increased healthcare use in the interim. Although patients who experience longer surgical wait times do not experience worse surgical outcomes, they may be at higher risk for readmission after surgery. Targeted interventions to optimize perioperative coordination of care for patients undergoing a hysterectomy for benign disease, especially those within vulnerable populations, are needed to improve quality of care, decrease any redundant or inefficient healthcare use, and reduce any unnecessary delays.
AB - Study Objective: To determine the impact of surgical wait time on healthcare use and surgical outcomes for patients undergoing hysterectomy for benign gynecologic indications. Design: Retrospective cohort study. Setting: Urban, academic tertiary care center. Patients: Patients who underwent hysterectomy for benign disease between 2012 and 2018. Interventions: None. Measurements and Main Results: Patients were categorized into 2 groups, dichotomized by surgical wait times >30 days or ≤30 days. Healthcare use was measured by the number of discrete patient interactions with the healthcare system through phone calls, secure electronic messaging, and office and emergency room visits. Univariate and multivariable logistic regression models were performed to assess the association between surgical wait time and healthcare use and perioperative outcomes while controlling for confounders. A total of 277 patients were included in our analysis: 106 (38.3%) had surgical wait times >30 days (median 47 days, range 24–68 days), and 171 (67.1%) had surgical wait times ≤30 days (median 19 days; range 12–26 days). The groups did not differ by age, insurance status, substance use, or comorbid conditions. Patients in the group with surgical wait times >30 days were more likely to have increased healthcare use (69 of 106, 65% vs 43 of 171, 25%; odds ratio 5.55; 95% confidence interval, 3.27–9.41). There were no differences in intraoperative complications (9 of 106, 8% vs 19 of 171, 11%; p =.482) or postoperative complications (28 of 106, 26% vs 32 of 171, 19%; p =.13) between the groups; however, after controlling for potential confounders, patients with surgical wait times >30 days were 3.22 times more likely to be readmitted than patients with surgical wait times ≤30 days (95% confidence interval, 1.27–8.19). Conclusion: A surgical wait time >30 days in patients undergoing a hysterectomy for benign disease is associated with increased healthcare use in the interim. Although patients who experience longer surgical wait times do not experience worse surgical outcomes, they may be at higher risk for readmission after surgery. Targeted interventions to optimize perioperative coordination of care for patients undergoing a hysterectomy for benign disease, especially those within vulnerable populations, are needed to improve quality of care, decrease any redundant or inefficient healthcare use, and reduce any unnecessary delays.
KW - Delay to surgery
KW - Healthcare use
KW - Perioperative outcomes
KW - Time to surgery
KW - Waiting for surgery
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U2 - 10.1016/j.jmig.2020.08.486
DO - 10.1016/j.jmig.2020.08.486
M3 - Article
C2 - 32891825
AN - SCOPUS:85092013182
SN - 1553-4650
VL - 28
SP - 982
EP - 990
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
IS - 5
ER -