The Influence of Hospital Type on 30-Day Emergency Department Visits after Benign Gynecologic Surgery

Abstract

Objective: The goal of this research was to examine how hospital type influences emergency department (ED) utilization within 30 days after benign gynecologic surgery. Materials and Methods: This was a pilot retrospective cohort study. Across 2 hospital settings-an academic medical center and a community-teaching hospital-adult women undergoing benign gynecologic surgery were placed randomly into 80 subject cohorts based on their 30-day postoperative ED utilization. The cohorts were defined as: (1) no ED visit; (2) low-yield ED visit (an ED visit with same-day discharge); and (3) high-yield ED visit (an ED visit with hospital admission). An analysis of risk factors for ED use according to hospital setting was performed. Results: Risk factors for ED use varied by hospital type. In the academic setting, Caucasian patients had fewer postoperative ED visits than patients of minority race/ethnicities, and insured patients had fewer postoperative ED visits than patients insured by Medicaid. In the academic setting, proximity to the hospital, performance of adhesiolysis, and prescription for an opiate were factors in frequency and types of ED visits. The need for catheterization was a factor in the type of ED visit only in the community-teaching setting, Conclusions: Hospital type influences use of emergency services following benign gynecologic surgery.