Continuity of Care After Day Surgery: The Role of Primary Care in Reducing Emergency Readmissions
Keywords:
Care, Emergency, Readmissions, discharge, ASA, GPAbstract
Patients leave the hospital within hours; much of the initial recovery care takes place beyond the hospital's four walls, making it sensitive to the transfer of information and responsibility from the surgical to the primary care team.
To determine if early primary care contact and related continuity-of-care measures are related to unplanned emergency return after day surgery within 30 days.
We carried out a cross-sectional study of 169 adults from Iraq with a study period from august 2025 to March 2026 discharged home after elective day surgery from a single multi-specialty unit. The data were obtained through a structured telephone interview on day 30 as well as hospital records. The result was any incidental presentation or emergency readmission that resulted from the surgical procedure. The primary care contact (consultation or telephone call) within 7 days of discharge was the main exposure. Analysis was done in IBM SPSS Statistics, using chi-square or Fisher’s exact tests, t-tests, Mann–Whitney tests, Spearman correlations, and binary logistic regression.
Twenty-three patients (13.6%) had an unplanned emergency return. This was 6.0% for those who consulted or visited primary care within seven days and 24.6% for those who did not (χ² = 12.06, p < 0.001). Results. Twenty-three patients (13.6%) had an unplanned emergency return. This was 6.0% for those who consulted or visited primary care within seven days and 24.6% for those who did not (χ² = 12.06, p < 0.001). Early primary care contact (OR 0.12; 95% CI 0.03 – 0.40) and a discharge summary delivered to the GP within 48 hours (OR 0.23; 0.08 – 0.66) were independently protective, whereas ASA grade III (OR 5.43; 1.46 – 20.17) and poorly controlled pain at discharge (OR 3.11; 1.09 – 8.86) were associated with higher odds. The model was able to discriminate well (AUC 0.858).
Fewer returns to the ER following day surgery were linked to early access to primary care and timely transfer of information. Due to its cross-sectional design, causality cannot be concluded, but results indicate that every day-surgery patient should be followed up in a structured manner in primary care, and those who have been sicker or in pain at discharge should be prioritized.
