Of 875 total patients identified, 675 who were case managed and 200 were not case managed. The BMI, marital status and race of the two groups were not significantly different. The zip code of the patient’s listed address was also collected given that patients are more likely to go to an ED closest to their residence and since the community health centers are spread throughout the county the patients attending these health centers may be more geographically diverse. The zip codes were then simplified into those adjacent or within the zip code of the hospital and those outside of the adjacent or hospital zip codes. The patient’s residential zip code did not demonstrate statistical significance. The mean age between the two groups were 40 for the case managed group and 36 for the non-case managed. This was statistically significant with a p value <0.05. The other statistically significant factor was surgical type with same day surgery being more common in the non-case managed group.
In Table 2, the surgical complications are listed. These were not statistically significant differences among the two groups with an overall complication rate of only 3.5% in total when accounting for intra-operative organ damage, reoperations, venous thromboembolism, death, unplanned admission to intensive care unit, infection, and transfusion of two or more units.
In total, 59 patients returned to the ED, for a return rate of 6.7% (59 out of 875 women). Six women returned twice and one woman returned three times.
In the case managed group, there were 29 single return visits to the ED and no one came back more than once. In the non-case managed group there were 23 single return visits to the ED, 6 people who returned twice and one who returned three times. The ED utilization rate among the non-case managed group was 15% for individual utilization of the ED. The case managed group ED utilization was 3.7%.
When controlling for variables for ED admission, only case management and surgical type demonstrated statistical significance. The odds of returning to the ED after inpatient surgery is 3 times that of after having same day surgery. Case management rendered an adjusted odds ratio of 0.235 the odds of returning for those that were not case managed. When controlling for other variables, the odds for returning to the ED for those not receiving case management was found to be 4.531 that of the case managed group when controlling for BMI, age, marital status, and type of surgery.