Mp57-01 Same Day Discharge After Holmium Laser Enucleation of the Prostate (Holep) Does Not Increase Postoperative Unanticipated Healthcare Utilization

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes II (MP57)1 May 2024MP57-01 SAME DAY DISCHARGE AFTER HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HOLEP) DOES NOT INCREASE POSTOPERATIVE UNANTICIPATED HEALTHCARE UTILIZATION Pablo A. Suarez, Maria C. Velasquez, Wilson Sui, Heiko Yang, Sultan Al Alzzawi, Jorge Mena, Justin Ahn, and Thomas Chi Pablo A. SuarezPablo A. Suarez , Maria C. VelasquezMaria C. Velasquez , Wilson SuiWilson Sui , Heiko YangHeiko Yang , Sultan Al AlzzawiSultan Al Alzzawi , Jorge MenaJorge Mena , Justin AhnJustin Ahn , and Thomas ChiThomas Chi View All Author Informationhttps://doi.org/10.1097/01.JU.0001009420.83948.eb.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Same day discharge (SDD) after holmium laser enucleation of the prostate (HoLEP) is increasingly performed but under studied. Evidence has shown SDD to have similar readmission rates and complications compared to postoperative admission. These measures do not capture all unanticipated contact with the healthcare system that drive cost and care quality, such as patient phone calls or unanticipated clinic visits. The goal of this study was to evaluate whether same day discharge increased unanticipated healthcare utilization in the postoperative period. METHODS: A retrospective cohort study of adult patients who underwent HoLEP at a single tertiary care academic center between 2018-2022 was performed. Demographic, clinical, disease-specific patient characteristics, and surgical outcomes were abstracted. Inclusion criteria for same day surgery were prostate size <150 g, ASA class 2 or less, and those patients living in close proximity to campus with family support. Primary outcomes were unanticipated healthcare utilization defined as unexpected emergency department/clinic visit or hospital readmission within the first 30 days after surgery. Secondary outcomes included postoperative complications. Students' T-tests, chi-square analysis and multivariable logistic regression models were used for analysis. RESULTS: Of 249 patients who underwent HoLEP, 25% (62) were discharged the same day. In comparison to overnight stay (OS). SDD patients had similar mean age (70.5±9.6 vs 73.3±7.5 years, p=0.15), and there were no differences in comorbidities such as diabetes, hypertension, and recurrent UTIs. Unanticipated postoperative healthcare utilization (Figure 1A) was similar between OS and SDD (11.23% vs 8.06%, p=0.388). There were also no differences in the rates of postoperative complications, including hematuria, UTI, and urinary retention (Figure 1B) or hospital readmission (2.14% vs 3.23%, p=0.629, Figure 1C). On multivariable logistic regression, SDD did not predict for healthcare re-engagement. CONCLUSIONS: Same day discharge after HoLEP did not increase postoperative complications, readmissions, or unanticipated healthcare utilization in properly selected. These data support that same day discharge HoLEP can be performed in a fashion that enhances quality and cost of care. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e936 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Pablo A. Suarez More articles by this author Maria C. Velasquez More articles by this author Wilson Sui More articles by this author Heiko Yang More articles by this author Sultan Al Alzzawi More articles by this author Jorge Mena More articles by this author Justin Ahn More articles by this author Thomas Chi More articles by this author Expand All Advertisement PDF downloadLoading ...