Reduced Returns to <scp>ED</scp> With Post‐Tonsillectomy and Adenoidectomy Chat Program: Outcomes and Costs

ABSTRACT Objective Patients who participate in the post‐surgical chat programs will have lower rates of emergency department (ED) visits when compared to those who do not participate. Methods Data from a texting program was used to stratify patients into those participating versus those not participating with the program. Individual patients' charts were reviewed for demographic information, if a postoperative ED visit related to surgery occurred, and if the ED visit was caused by a failure of patient education regarding the treatment plan or by expected postoperative symptoms. Odds ratios compared the ED visit rates between participating and non‐participating families. Cost was analyzed by comparing published data on ED visit costs with internal data on chat program cost. Results During the study (2/2022–3/2023), 1059 unique patients (children/caregiver dyads) were enrolled in the chat. Five hundred and fifty‐eight patients (52.7%) participated in one or more chats while 501 patients (47.3%) did not participate. Of note, patients with public insurance were less likely to participate. Non‐participants were 9.12 times more likely to visit the ED postoperatively due to a communication lapse ( p = 0.047). Estimated savings from 1 year of avoided ED visits did not outweigh the chat program's expense. Conclusions Utilization of an automated messaging system for frequently asked questions after pediatric tonsillectomy demonstrated a statistically significant reduction in ED visits and readmissions related to postoperative complications and questions, but an increase in health care costs. Level of Evidence 3