LAUSR

Study Objective To determine the impact of surgical wait time on healthcare utilization and surgical outcomes for women undergoing hysterectomy for benign gynecologic indications. Design Retrospective cohort study. Setting Urban, academic tertiary care center. Patients Women who underwent hysterectomy for benign disease between 2012 and 2018. Interventions None Measurements and Main Results Women were divided into two groups, dichotomized by surgical wait times > or ≤ 30 days. Healthcare utilization was measured by the number of discrete patient interactions with the healthcare system via phone calls, secure electronic messaging, office and emergency room visits. Univariate and multivariable logistic regression models were performed to assess the association between surgical wait time and healthcare utilization and perioperative outcomes while controlling for confounders. Two hundred and seventy-seven women were included in our analysis: 106 (38.3%) had surgical wait time >30 days (median 47 days, range 24-68 days) and 171 (67.1%) had surgical wait time ≤30 days (median 19 days; range 12-26 days). The groups did not differ by age, insurance status, substance use or comorbid conditions. Women in the surgical wait time >30 days group were more likely to have increased healthcare utilization (69/106, 65% vs 43/171, 25% OR 5.55 95% CI 3.27-9.41). There were no differences in intraoperative complications (9/106, 8% versus 19/171, 11%, p = .482) or postoperative complications (28/106, 26% vs 32/171, 19%, p = .13) between the groups; however, after controlling for potential confounders, women with surgical wait time >30 days were 3.22 times more likely to be readmitted than women with surgical wait time ≤30 days (95% CI 1.27-8.19). Conclusion Surgical wait time >30 days in women undergoing hysterectomy for benign disease is associated with increased healthcare utilization in the interim. Though women who experience longer surgical wait times do not experience worse surgical outcomes, they may be at higher risk for readmission after surgery. Targeted interventions to optimize perioperative coordination of care for women undergoing hysterectomy for benign disease, especially those within vulnerable populations, are needed to improve quality of care, decrease any redundant or inefficient healthcare usage, and reduce any unnecessary delays.