Impact of early primary care physician follow-up on hospital readmission following gastrointestinal cancer surgery

J Surg Oncol. 2024 Aug;130(2):241-248. doi: 10.1002/jso.27696. Epub 2024 May 27.

Abstract

Background: We sought to examine the association between primary care physician (PCP) follow-up on readmission following gastrointestinal (GI) cancer surgery.

Methods: Patients who underwent surgery for GI cancer were identified using the Surveillance, Epidemiology and End Results (SEER) database. Multivariable regression was performed to examine the association between early PCP follow-up and hospital readmission.

Results: Among 60 957 patients who underwent GI cancer surgery, 19 661 (32.7%) visited a PCP within 30-days after discharge. Of note, patients who visited PCP were less likely to be readmitted within 90 days (PCP visit: 17.4% vs. no PCP visit: 28.2%; p < 0.001). Median postsurgical expenditures were lower among patients who visited a PCP (PCP visit: $4116 [IQR: $670-$13 860] vs. no PCP visit: $6700 [IQR: $870-$21 301]; p < 0.001). On multivariable analysis, PCP follow-up was associated with lower odds of 90-day readmission (OR: 0.52, 95% CI: 0.50-0.55) (both p < 0.001). Moreover, patients who followed up with a PCP had lower risk of death at 90-days (HR: 0.50, 95% CI: 0.40-0.51; p < 0.001).

Conclusion: PCP follow-up was associated with a reduced risk of readmission and mortality following GI cancer surgery. Care coordination across in-hospital and community-based health platforms is critical to achieve optimal outcomes for patients.

Keywords: cancer; care coordination; primary care physician; readmission risk; surgical outcomes.

MeSH terms

  • Aftercare / economics
  • Aftercare / statistics & numerical data
  • Aged
  • Digestive System Surgical Procedures
  • Female
  • Follow-Up Studies
  • Gastrointestinal Neoplasms* / surgery
  • Humans
  • Male
  • Middle Aged
  • Patient Readmission* / economics
  • Patient Readmission* / statistics & numerical data
  • Physicians, Primary Care* / statistics & numerical data
  • Postoperative Complications / epidemiology
  • SEER Program*