Surgical service and distance traveled drive patient preference for Care Hotel: a retrospective cohort study

Michael J Maniaci; Ryan M Chadha; Jacey R Fazio; Karla C Maita; Ellen A Love; Venessa L Boyle; Michael G Heckman; Patrick W Johnson; Margaret R Paulson; Antonio J Forte

doi:10.1097/MS9.0000000000000704

Surgical service and distance traveled drive patient preference for Care Hotel: a retrospective cohort study

Ann Med Surg (Lond). 2023 Apr 19;85(5):1578-1583. doi: 10.1097/MS9.0000000000000704. eCollection 2023 May.

Authors

Affiliations

¹ Division of Hospital Internal Medicine.
² Department of Anesthesiology.
³ Advanced Care at Home.
⁴ Division of Plastic Surgery.
⁵ Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, FL.
⁶ Division of Hospital Internal Medicine, Mayo Clinic Health Systems, Eau Claire, Wisconsin.

Abstract

Mayo Clinic's Care Hotel is a virtual hybrid care model which allows postoperative patients to recover in a comfortable environment after a low-risk procedure. Hospitals need to understand the key patient factors that promote acceptance of the Care Hotel if they are to benefit from this innovative care model. This study aims to identify factors that can predict whether a patient will stay at Care Hotel.

Materials and methods: This retrospective chart review of 1065 patients was conducted between 23 July 2020, and 31 December 2021. Variables examined included patient age, sex, race, ethnicity, Charlson comorbidity index, distance patient travelled to hospital, length of surgery, day of the week of surgery, and surgical service. Associations of patient and surgery characteristics with the primary outcome of staying at the Care Hotel were assessed using unadjusted and multivariable logistic regression models.

Results: Of the 1065 patients who met criteria for admission to the Care Hotel during the study period, 717 (67.3%) chose to stay at the Care Hotel while 328 (32.7%) choose to be admitted to the hospital. In multivariable analysis, there was a significant association between surgical service and staying at the Care Hotel (P<0.001). Specifically, there was a higher likelihood of staying at the Care Hotel for patients from Neurosurgery [odds rato (OR)=1.86, P=0.004], Otorhinolaryngology (OR=2.70, P<0.001), and General Surgery (OR=2.75, P=0.002). Additionally, there was a higher likelihood of staying at the Care Hotel with distance travelled over 110 miles [OR (per each doubling)=1.10, P=0.007].

Conclusion: When developing a post-surgical care model for patients following outpatient procedures, the referring surgical service is a primary factor to consider in order to ensure patient acceptance, along with patient distance. This study can assist other healthcare organizations considering this model, as it provides guidance on which factors are most indicative of acceptance.

Keywords: care hotel; patient drivers; post-surgical; telemedicine; virtual hybrid.