A proactive model of general medicine perioperative care was significantly associated with a lower likelihood of MET calls, referrals to other subspecialties, and take-over of care.
Cross-Sectional (n=1,071)
Yes
Does a proactive model of perioperative care improve clinical outcomes in adult surgical patients referred to general medicine?
Proactive models of general medicine perioperative care may improve clinical outcomes such as reducing MET calls and take-over of care in high-risk surgical patients.
AIM: To evaluate the models of general medicine perioperative services and describe the characteristics and outcomes of perioperative referrals. METHODS: A multicentre cross-sectional study involving 11 Victorian public hospitals was conducted over 6 weeks at each site. Adult patient (≥18 years old) referrals from all surgical services were included. Comparative analyses of outcomes based on models of care were undertaken and adjusted for covariates. RESULTS: The overall service activity was 427 (95% CI: 403-453) referrals per 10 000 surgical admissions per year. Of 1071 referrals, 922 (86.1%) were inpatients and 759 (70.9%) were emergency instances. Median age was 73 (62-83) years and 45.5% were females. Median Charlson Comorbidity Index was 5 (3-6) and clinical frailty scale was 4 (3-5). The most common referral requests were for preoperative risk assessment and optimisation, management of postoperative medical complications and diagnostic input. Clinical outcomes included 43 (4.3%) deaths, 73 (7.9%) medical emergency team (MET) responses and 32 (3.5%) intensive care admissions within 48 h and 116 (11.6%) take-over of care instances. Proactive model of care was significantly associated with fewer MET calls, shorter length of stay, fewer referrals to other subspecialties and take-over of care and higher rates of returning to usual residence. Lower likelihood of MET calls, referral to other subspecialties and take-over of care remained statistically significant in multivariable analyses. CONCLUSIONS: General medicine perioperative services provide care to older, co-morbid, frail and high-risk surgical patients across all perioperative settings. General physicians' role in perioperative care is diverse and wide-ranging. Well-resourced proactive models of perioperative care may confer better outcomes for patients.
Aung et al. (2025) conducted a cross-sectional in Surgical patients requiring perioperative care (n=1,071). Proactive model of care vs. Other models of care was evaluated on Clinical outcomes including MET calls, length of stay, referrals to other subspecialties, and take-over of care. A proactive model of general medicine perioperative care was significantly associated with a lower likelihood of MET calls, referrals to other subspecialties, and take-over of care.