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Streamlining Insurance Based Breast Reduction
Elise Hogan, BS, Suma Yalamanchili, MD, Ellie Farley, BA, Sarah Beth Guibord, DNP, MSN, BSN, Sarah Strauss, DNP, MSN, BSN, Ryan Gobble, MD
University of Cincinnati College of Medicine
2022-01-13
Presenter: Elise Hogan
Affidavit:
Medical student; data acquisition and composition.
Director Name: Ann Schwentker
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Purpose: To identify a process to streamline the evaluation of prospective breast reduction patients
Methods: This was a retrospective review of patients interested in breast reductions who presented to our academic institution from March 2015 through August 2021. Patients first attended a nurse practitioner (NP) class where they were screened for institutionally defined exclusion criteria prior to scheduling an in-person consultation with an NP. Patient charts were reviewed with a surgeon prior to submitting to insurance. Once approved, patients were then scheduled a preoperative visit with a surgeon.
Results: 1310 unique patients were identified as enrolled for the class. There was a 36.82% no show rate for the breast reduction class. 973 patients ultimately attended the class, and 386 patients were offered an in person visit with the NP (39.67%). 82 patients no showed their scheduled NP visits (20.15%). Average Schnur value was 735 grams. Average estimated gram reduction by the NP was 580g. 212 patients were then scheduled with an attending physician, to which 15 visits were no showed (7.08%). On average, the NP estimation was 189g less than the attendings' estimation. 171 patients underwent a bilateral breast reduction. The nurse practitioner estimation was on average 306 grams less than the actual resection weight, and the attending estimated reduction was on average 110 grams less. Complication rate was 21.05%.
Conclusion: A nurse practitioner is able to estimate a breast reduction gram reduction, thus decreasing the number of visits and no-show appointments for a surgeon.
