Older patients are significantly more likely than their younger counterparts to end up in the hospital following outpatient surgery, according to new research out of Northwestern University, but there are ways physicians can reduce this risk, reported U.S. News & World Report.
Patients older than 65 were 54 percent more likely to land in the hospital within 30 days of outpatient surgery than non-seniors, according to the research, published in the Journal of the American Geriatrics Society. The analysis of more than 53,000 cases revealed, however, that it wasn't age-related illness acuity that upped hospitalization risk, but seniors' difficulty in carrying out discharge instructions, according to study author Gildasio De Oliveira Jr., M.D., an assistant professor in the Center for Healthcare Studies at Northwestern University's Feinberg School of Medicine in Chicago.
Physicians' first step in avoiding such hospitalizations, therefore, is to evaluate patients' home situation. "Before allowing patients to get ambulatory [outpatient] surgery, surgeons also should verify if patients are able to take care of themselves at home, and if they have support," De Oliveira wrote. "If not, patients should be admitted to the hospital after surgery or have some type of formal support by a nurse to help them at home."
Medication instructions and dosage can be particularly challenging for older individuals to understand, researchers noted. There are four immediate steps, however, healthcare providers can take to help improve health literacy of patients of all ages, FiercePracticeManagment reported previously.
Research also has shown that it pays for primary care offices to help coordinate care. A study from JAMA Surgery, for example, found that early follow-up with a primary care physician significantly reduced the risk for readmission in heart surgery patients who had perioperative complications. Similarly, a pilot program that involved four primary care clinics in Oregon showed that improved care coordination between inpatient and outpatient clinicians reduced 30-day readmissions from 27 percent to 7.1 percent.
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