Domestic surgical tourism may have dire consequences: study

por Lauren Dubinsky, Senior Reporter | June 18, 2015
Emergency Medicine Risk Management
University of Utah Health Care
If a patient experiences unexpected complications after surgery, it’s important for them to return to the same hospital for recovery, according to a new University of Utah study. Patients have a 26 percent higher chance of dying within 90 days if they are readmitted to a different hospital.

The researchers evaluated data from 9,440,503 Medicare patients who were readmitted within 30 days after undergoing a major surgical procedure between 2001 and 2011. They found that 66 to 83 percent of patients who had complications were readmitted to the same hospital and were more likely to survive 90 days after readmission than those who were treated in a different hospital.

The trend was consistent among a range of different surgeries — there was a 44 percent decrease in risk of death for those who underwent pancreatectomy and 13 percent for those who underwent coronary bypass surgery. The findings were also consistent across large teaching hospitals and smaller community hospitals.

The patients also had better outcomes if they were treated by the same surgical team. That was particularly true for many common operations including neurosurgery, coronary bypass and hernia repair.

Some of the largest U.S. businesses are involved in medical travel programs in which lower prices are negotiated so patients can receive high-quality surgical care at some of the nation’s top hospitals. But many of those patients have to travel long distances to get to those hospitals, which makes it hard for them to return if they experience complications.

"Most people do not think about the implications of traveling far for an operation," Dr. Sam Finlayson, senior author and professor and chair of surgery at the university, said in a statement. "As with many health care decisions, there are trade-offs to consider. Traveling may confer the best chance of a favorable outcome with surgery, but it may hinder access to optimal care in the event of a serious complication after discharge."

The researchers are interested in finding out why outcomes are better when a patient returns to a hospital that performed their operation. They believe that discovering the answers may help enhance the way care is delivered.

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