Benefits of Performing Same Day Discharge LEAD and Varicose Interventions in Active Patients

International audienceBackground In France, 90% of varicose vein interventions are performed in ambulatory setting while it concerns 7% of angioplasty for lower extremities arterial disease (LEAD). In this study, we made the hypothesis that such disparities may partly be due to the burden of the post-procedural rehabilitation and its relation to patients’ care-pathway and coordination. Methods A retrospective study was conducted on 18 to 65 years old active population who benefited from varicose or LEAD interventions from January 2013 to June 2016 using data from the French National Health Insurance System. Post-procedural rehabilitation measure was the number of cumulated workday break and their renewals within 180 days after intervention. Negative binomial regressions, adjusted for age, gender, and comorbidities, were applied to test associations. The degree of coordination among health care professionals for post-procedural follow-up was tested using the continuity of care and the continuity of prescription indices. Results Compared to inpatient care, day interventions decrease the incidence rate ratio (IRR) of cumulated workday breaks by 14% in both varicose vein and LEAD interventions. The decrease in the degree of coordination between care providers increase the IRR of cumulated workday breaks and renewals by 37% and 29% respectively for varicose, and 11% and 9% for LEAD interventions. The increase in the number of work break prescriptions delivered by the same category of providers decreases the IRR of cumulated workday breaks and their renewals in varicose by 25% and 21% but increases them in LEAD interventions by 240% and 106%. Conclusions Day interventions have similar impacts on rehabilitations after varicose vein and LEAD interventions. However, coordination is critical. Our results highlight the need to pursue health regulatory agencies and healthcare professionals’ works on multidisciplinary ambulatory care networks for better follow-up of acute day care interventions. Key messages Day intervention reduces cumulated workday breaks in endovascular interventions. Multi-specialty coordination of the qualified health care professionals is required in endovascular interventions, especially after angioplasty for LEAD in outpatient settings