How Long Do I Have to Follow This Patient?

The average follow-up for surgical procedures varies widely and there is limited data to help us make informed decisions. Each visit outside of the global package incurs a cost for the patient, and there is also a cost to the surgeons in terms of their capacity to see new patients.

PROMIS as a guide

The study ”Using PROMIS Scores to Provide Cost-\Conscious Follow-up After Foot and Ankle Surgery” by Hunter et al. explored whether patients can best determine their need for further follow-up based on a documented improvement of two PROMIS scores.  

The study

Retrospective PROMIS PI data were obtained for common elective foot (n = 759) and ankle (n = 578) surgical procedures. Substantial improvement was defined as having two consecutive postoperative minimal clinically important differences above preoperative PROMIS scores. After achieving substantial improvement, foot and ankle patients averaged 3.60 and 4.01 follow-up visits during the remaining nine months of the year where the average visit costs were $266 and $322 per foot and ankle patient, respectively. Maybe there is a structure where patients are not routinely followed unless triggered by a negative change in their outcomes.