Unplanned Emergency and Urgent Care Visits After Outpatient Orthopaedic Surgery

Benjamin R. Williams, Lauren C. Smith, Arthur J. Only, Harsh R. Parikh, Marc F. Swiontkowski, Brian P. Cunningham

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


IntroductionThis study sought to determine (1) incident risk, (2) chief report, (3) risk factors, and (4) total cost of unplanned healthcare visits to an emergency and/or urgent care (ED/UC) facility within 30 days of an outpatient orthopaedic procedure.MethodsThis was a retrospective database review of 5,550 outpatient surgical encounters from a large metropolitan healthcare system between 2012 and 2016. Statistical analysis consisted of measuring the ED/UC incident risk, respective to the procedures and anatomical region. Patient-specific risk factors were evaluated through multigroup comparative statistics.ResultsOf the 5,550 study patients, 297 (5.4%) presented to an ED/UC within 30 days of their index procedure, with 23 (0.4%) needing to be readmitted. Native English speakers, patients older than 45 years, and nonsmokers had significant reduced relative risk of unplanned ED or UC visit within 30 days of index procedure (P < 0.01). In addition, hand tendon repair/graft had the greatest risk incidence for ED/UC visit (11.0%). Unplanned ED/UC reimbursements totaled $146,357.34, averaging $575.65 per visit.DiscussionThis study provides an evaluation of outpatient orthopaedic procedures and their relationship to ED/UC visits. Specifically, this study identifies patient-related and procedural-related attributes that associate with an increased risk for unplanned healthcare utilization.

Original languageEnglish (US)
Article numbere21.00209
JournalJournal of the American Academy of Orthopaedic Surgeons Global Research and Reviews
Issue number9
StatePublished - Sep 20 2021

Bibliographical note

Funding Information:
Dr. Swiontkowski is the Editor of JBJS. Dr. Cunningham has received grant funding from Integra. Dr. Cunningham's spouse is the CEO of CODE Technology. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article Dr. Williams, Dr. Smith, Dr. Only, Dr. Parikh.

Publisher Copyright:
© American Academy of Orthopaedic Surgeons.


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