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ER Visits Common After Seniors' Surgery, Study Finds

TUESDAY, Sept. 10 (HealthDay News) -- After common surgeries, nearly one in five older Americans ends up in the emergency department within a month of being discharged from the hospital, according to a new study.

The University of Michigan Medical School researchers also found wide variation among hospitals in the rates of older patients who needed emergency department care after having surgery on their hearts, hips, backs, colons and major blood vessels. Rates were as much as four times higher in some hospitals than in others.

"There was a lot of variation depending on what the surgery was for," study lead author Dr. Keith Kocher, an emergency physician and assistant professor in the department of emergency medicine, said in a university news release.

For example, rates of ER visits after colon surgery ranged from one in four patients at some hospitals to one in 14 patients at others.

The researchers analyzed data from nearly 2.4 million Medicare patients who had at least one of six common operations over a three-year period. More than 4 percent of them had two or more emergency department visits within one month after leaving the hospital.

The study team also found that more than half of the patients who required emergency care were readmitted to the hospital directly from the ER, according to the study published in the September issue of the journal Health Affairs.

The six types of surgery included in the study were: angioplasty or other minimally invasive heart procedures; coronary artery bypass; hip fracture repair; back surgery; elective abdominal aortic aneurysm repair; and removal of part of the colon to treat problems such as colon cancer.

The most common issues that brought patients to the emergency department were cardiovascular and respiratory conditions, infections, complications with the site of their surgery or procedure incision, and abdominal or gastrointestinal problems.

"We went into this expecting some variation, but were surprised at how much we found," Kocher said. "That means this is probably a finding health providers and systems can act on to improve their rates, to ensure coordination of care and that patients can access timely care for problems that develop after they are discharged before having to come to the emergency department."

If further research supports it, post-surgical emergency department visits could be added to other measures such as infection rates in assessing and grading hospitals on their quality of care, according to the study authors.

More information

The U.S. National Institute on Aging has more about surgery.

SOURCE: University of Michigan Health System, news release, Sept. 9, 2013

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