Introduction

Quality of care delivery may improve patient outcomes post-bariatric surgery. We examined the quality of post-discharge phone calls (Ph_DC) to determine the impact on early (< 90 day) non-urgent hospital returns (NUHR) following primary bariatric surgery.

Methods

A retrospective review was performed on patients who underwent Roux-en-Y-gastric bypass (RYGB) or sleeve gastrectomy (SG) in 2019. Patients were compared between presence of care coaching (Jan–June 2019) versus no care coaching (July–Dec 2019). Baseline demographics, comorbidities, psychiatric history, and Ph_DC were collected. Index Ph_DCs were coded for completeness using a scoring system and rated by call quality. Patients were stratified into NUHR versus control group (Never returns [NR]). Primary analysis examined the impact of Ph_DC on NUHR. Sub-analysis examined the impact of call quality. Univariate analysis was performed using Chi-square or Fisher’s exact tests. Multivariate analysis (MVA) was used to determine predictors of NUHR. A p-value of ≤ 0.05 was statistically significant.

Results

A total of 359 patients were included. Compared to the NR group (n = 294), NUHRs (n = 65) were more likely to be younger (41.3 + 12.1 versus 45.0 + 10.8 years, p = 0.024), with baseline anxiety (41.5% versus 23.5%, p = 0.003), and undergo RYGB (73.3% versus 57.8%, p = 0.031). There was a significant difference in number of Ph_DC in the NUHR and NR groups (p = 0.0206). Care-coached patients had significantly higher rates of high-quality phone calls (p < 0.0001) compared to non-care-coached patients. MVA demonstrated younger age (OR = 0.97, CI: 0.95–1.00; p = 0.023), anxiety (OR = 2.09, CI: 1.17–3.73; p = 0.012), RYGB (OR = 1.88, CI: 1.02–3.45; p = 0.042), and > 50% call quality versus no Ph_DC (OR = 0.45, CI: 0.25–0.83; p = 0.010) were independently associated with NUHRs.

Conclusion

High-quality Ph_DCs may play a role in mitigating NUHRs. Care coaching represents a potential intervention to decrease high rates of NUHR in primary bariatric surgery patients.

中文翻译：

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初次减肥手术后 90 天内出院后电话对非紧急医院返回的影响

介绍

护理质量可以改善减肥手术后的患者预后。我们检查了出院后电话 (Ph _DC ) 的质量，以确定对初次减肥手术后早期（< 90 天）非紧急医院返回 (NUHR) 的影响。

方法

对 2019 年接受 Roux-en-Y-胃旁路术 (RYGB) 或袖状胃切除术 (SG) 的患者进行了回顾性研究。比较了有护理指导（2019 年 1 月至 6 月）与没有护理指导（2019 年 7 月至 10 月）的患者。 2019 年 12 月）。 收集了基线人口统计学、合并症、精神病史和 Ph _{DC 。}Index Ph _DC使用评分系统对完整性进行编码，并按通话质量进行评级。患者被分为 NUHR 与对照组（永不返回 [NR]）。_{主要分析检查了 Ph DC} 对 NUHR的影响。子分析检查了通话质量的影响。使用卡方检验或 Fisher 精确检验进行单变量分析。多变量分析 (MVA) 用于确定 NUHR 的预测因子。Ap _-≤ 0.05 的值具有统计学意义。

结果

总共包括 359 名患者。与 NR 组 ( n  = 294) 相比，NUHRs ( n  = 65) 更可能更年轻（41.3 + 12.1 vs 45.0 + 10.8 岁，p  = 0.024），基线焦虑（41.5% vs 23.5%，p  = 0.003)，并接受 RYGB（73.3% 对 57.8%，p  = 0.031）。 NUHR 和 NR 组的Ph _DC数量存在显着差异( p  = 0.0206)。 与未接受护理指导的患者相比，接受护理指导的患者拨打高质量电话的比例明显更高 ( p < 0.0001)。MVA 显示年龄较小（OR = 0.97，CI：0.95–1.00；p  = 0.023），焦虑（OR = 2.09，CI：1.17–3.73；p  = 0.012）、RYGB（OR = 1.88，CI：1.02–3.45；p  = 0.042）和 > 50% 的通话质量与无 Ph _DC（OR = 0.45，CI：0.25–0.83；p  = 0.010）独立相关与 NUHR。

结论

高质量的 Ph _DC可能在减轻 NUHR 方面发挥作用。护理指导代表了一种潜在的干预措施，可以降低初次减肥手术患者的高 NUHR 发生率。