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- Title
Preoperative Educational Intervention Decreases Unplanned Gastrostomy-Related Health Care Utilization.
- Authors
BARRY, WESLEY E.; BARIN, ERICA N.; MARSHALL, LORI C.; DOHERTY, MAJELLA; NGUYEN, EUGENE; MCLAUGHLIN, CORY; KAPLAN, LUCAS; STEIN, JAMES E.; JENSEN, AARON R.
- Abstract
Apprehension in taking independent care of children with medical devices may lead to unnecessary visits to the ED and/or acute clinic (AC). To address these concerns, our institution implemented a gastrostomy tube (GT) class in 2011 for caretakers. We hypothesized that inappropriate GT-related ED/AC visits would be lower in preoperatively educated caregivers. We performed a retrospective cohort study of all patients aged 0 to 18 who received GT (surgical or percutaneous) at our institution between 2006 and 2015 (n = 1340). Class attendance (trained vs untrained) and unscheduled GT-related ED/AC visits one year after GT placement were reviewed. Gastrostomy-related ED/AC visits were classified as appropriate (hospital-based intervention) or inappropriate (site care and education/reassurance). Occurrence of ED/AC visits was compared between trained and untrained cohorts. We found that 59 per cent of patients had an unscheduled GT-related ED/AC visit within one year of placement. The trained cohort had 27 per cent less unplanned ED/AC visits within one year (mean 1.21 (SD 1.82) vs untrained 1.65 (2.24), P < 0.001). On multivariate analysis, GT education independently decreased one-year GT-related health care utilization (Odds Ratio 0.75, 95% Confidence Interval 0.59-0.95). Formal education seems to decrease GT-related health care utilization within one year of placement and should be integrated into a comprehensive care plan to improve caregiver self-efficacy.
- Subjects
MEDICAL care; PERCUTANEOUS endoscopic gastrostomy; MEDICAL education; EMERGENCY medicine; PUBLIC health; OUTPATIENT medical care; CAREGIVERS; GASTROSTOMY; LENGTH of stay in hospitals; LONGITUDINAL method; PATIENT education; PREOPERATIVE care; GASTRIC intubation; SURGICAL complications; UNNECESSARY surgery; BURDEN of care; RETROSPECTIVE studies; PATIENTS' attitudes; ECONOMICS
- Publication
American Surgeon, 2018, Vol 84, Issue 10, p1555
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/000313481808401003