Pre-Surgery Virtual versus Office Visits: An Analysis of Patient Outcomes

Objectives: To determine surgical outcomes for virtual compared to office pre-surgery visits.

Methods: A retrospective cohort review was performed on patients who had a pre-surgery virtual or office visit and subsequent surgery between 10/2019 and 12/2022 in a minimally invasive gynecologic surgery practice. We excluded patients with both virtual and office pre-surgery visits. Data collected included patient demographics, type of surgery, number of preoperative visits and phone calls, number of post-surgery phone calls, emergency room visits and admissions, reoperations, and costs. Virtual and office visits were compared.

Results: A total of 976 patients (77.6%) had virtual visits, and 282 patients (22.4%) had office visits (Table 1). Patients who had virtual visits were younger than those with office visits (mean 39.2 vs. 42.4 years, p< 0.001). Other baseline characteristics did not differ between groups.

The mean number of pre-surgery visits was lower in the virtual visits group (2.8 vs. 3.1, p=0.009), as was the number of phone calls (1.5 vs. 1.9, p< 0.001).

The proportion of laparoscopic surgeries was similar in both groups. Compared to the office visits groups, women with virtual visits had fewer hysterectomies (28.5% vs. 35.5%, p=0.024), and more endometriosis excisions (54.4% vs 39.7%, p< 0.001). Surgery length was shorter in the virtual visit group (mean 119.7 vs. 136.9 minutes, p=0.001). However, total hospital admission time did not differ between groups.

Compared to patients who had in office visits, patients with virtual visits had more post-surgery visits (mean 0.09 vs. 0.8 visits, p=0.013, Table 2), but fewer post-surgery phone calls (0.9 vs. 1.5, p< 0.001).

There was no difference post-surgery between the two groups in emergency department visits, admissions, or reoperations. These results remained unchanged in sub-analyses by surgery types: hysterectomy, endometriosis excision or myomectomy.

Total costs were lower in the pre-surgery virtual visit group (111246.2 vs. 121975.9 USD, p=0.004). However, in multivariable regression analysis, the type of pre-surgery visit was not independently associated with total costs [aOR 1.00 (0.60-1.68), p=0.988].

Conclusions: Pre-surgery virtual and office visits result in similar surgical outcomes, and virtual pre-surgery visits can be considered as an alternative to pre-surgery office visits.