Reduced Returns to ED With Post-Tonsillectomy and Adenoidectomy Chat Program: Outcomes and Costs.

Abstract

Patients who participate in the post-surgical chat programs will have lower rates of emergency department (ED) visits when compared to those who do not participate. Data from a texting program was used to stratify patients into those participating versus those not participating with the program. Individual patients' charts were reviewed for demographic information, if a postoperative ED visit related to surgery occurred, and if the ED visit was caused by a failure of patient education regarding the treatment plan or by expected postoperative symptoms. Odds ratios compared the ED visit rates between participating and non-participating families. Cost was analyzed by comparing published data on ED visit costs with internal data on chat program cost. During the study (2/2022-3/2023), 1059 unique patients (children/caregiver dyads) were enrolled in the chat. Five hundred and fifty-eight patients (52.7%) participated in one or more chats while 501 patients (47.3%) did not participate. Of note, patients with public insurance were less likely to participate. Non-participants were 9.12 times more likely to visit the ED postoperatively due to a communication lapse (p = 0.047). Estimated savings from 1 year of avoided ED visits did not outweigh the chat program's expense. Utilization of an automated messaging system for frequently asked questions after pediatric tonsillectomy demonstrated a statistically significant reduction in ED visits and readmissions related to postoperative complications and questions, but an increase in health care costs.