Physician assistant follow-up visits can cut cardiac surgery costs, readmissions

Follow-up home visits from a physician's assistant (PA) reduced complications and costs associated with cardiac surgery, according to a new study.

The research, presented at the annual Meeting of The Society of Thoracic Surgeons, found that when a PA visited a cardiac surgery patient twice within five days of discharge, it led to a 10 percent readmission rate within 30 days of discharge. That compares to a 17 percent readmission rate for patients who did not receive such follow-up visits.  

The cohort studied was a group of 1,185 patients who underwent cardiac surgery between September 2008 and August 2012 at Staten Island University Hospital in New York City. Of those patients, 363 received follow-up care visits from PAs on days two and five after discharge.

"Adult cardiac surgery has one of the highest readmission rates for all hospitalized patients," John P. Nabagiez, M.D., a Staten Island University surgeon and the study's lead author, said in a statement about the findings. "Our study was designed to determine if two home visits by a physician assistant could help reduce readmission rates following heart surgery."

Unlike standard visiting nurses who meet with patients for the first time after their discharge from a hospital, Nabagiez said the PAs knew each patient personally and understood all of the pertinent issues of the patient's medical history. They also knew the patient's individual postoperative course prior to discharge and any concerns of the surgeon and patient.

Although the follow-up visits cost $23,500, researchers estimated the home visits saved $977,500 in overall costs due to the lower rates of readmission among that group. 

The issue of whether home healthcare can cut costs and complications was explored in a recent study by UCLA and Harvard researchers who concluded that it may lead to fewer complications and readmissions for surgical patients versus referrals to post-acute inpatient providers.

And while PAs have shown to both increase patient satisfaction and outcomes, they are still often not considered a direct component in lowering the costs and raising the value of care being delivered.

To learn more:
- read the study announcement

Read more on