Exploring disparities and mitigating factors for adherence to post-surgery follow-up care

Follow-up after surgery is critical to check possible signs and symptoms of poor function, pain and infection. Families that experience barriers to attending appointments are at risk for lack of follow-up care, potentially affecting their surgical outcome. We are conducting a retrospective cohort study using 2022 data from surgical patients at Seattle Children's. Our main goal is to examine disparities in outpatient surgical follow-up related to race/ethnicity and language of care. Additionally, we are exploring the impact of language interpretation on mitigating these identified disparities.

Approximately 3.9 million pediatric surgeries occur annually in the United States. In 2022, Seattle Children’s performed 14,790 inpatient and outpatient surgeries. Post-surgical outpatient follow-up is key for assuring optimal surgical outcomes since pain control and rehabilitation needs are evaluated to facilitate reintegration into usual daily life activities.

Follow-up care after hospital discharge is also associated with reduced rates of readmission and improved short- and long-term health outcomes. However, up to 64% of parents are unaware of follow-up appointments, and studies show that 28% to 62% of families miss follow-up appointments after hospital discharge.

Among minoritized racial and ethnic groups and patients whose language of care is not English, missed follow-up appointments are higher compared to the general population.

Most studies looking at transitions of care focus on discharge from the emergency department and overall inpatient care. The existing research for pediatric post-surgical follow-up care is limited, and the existing few studies are procedure-specific or single specialty.

Families from minoritized racial/ethnic groups, as well as those whose language of care is not English, face additional barriers to access care, with lack of insurance and under-insurance, transportation and communication barriers explaining some of the documented disparities.

Importantly, there is evidence that providing care coordination and consistent utilization of professional interpreters is associated with better access to post-trauma care and, among surgical patients, better postoperative pain control.

Following Seattle Children’s commitment to equitable health care, we are conducting a retrospective cohort study using existing data for Seattle Children’s surgical patients for the year 2022 to explore disparities in outpatient surgical follow-up by race/ethnicity and language of care; and to examine if the utilization of language interpretation mitigates these disparities.