A methodology to estimate the potential to move inpatient to one day surgery
| Autor: | Nicolas Gilliard, Yves Eggli, Patricia Halfon |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Patient Transfer
Current Procedural Terminology medicine.medical_specialty Eligibility Determination Risk Assessment Health informatics Health administration Patient Admission medicine Humans Minimally Invasive Surgical Procedures Reimbursement Incentive Inpatients Algorithms Ambulatory Surgical Procedures Emergencies Endoscopy Feasibility Studies Length of Stay Organ Size Patient Selection Surgical Procedures Elective Surgical Procedures Minimally Invasive Switzerland Treatment Outcome United States business.industry lcsh:Public aspects of medicine Health Policy Nursing research lcsh:RA1-1270 Ambulatory Surgical Procedure medicine.disease Surgery Elective Surgical Procedures Medical emergency Elective Surgical Procedure business Risk assessment Research Article |
| Zdroj: | BMC Health Services Research BMC health services research, vol. 6, no. 78 BMC Health Services Research, Vol 6, Iss 1, p 78 (2006) |
| ISSN: | 1472-6963 |
| Popis: | BackgroundThe proportion of surgery performed as a day case varies greatly between countries. Low rates suggest a large growth potential in many countries. Measuring the potential development of one day surgery should be grounded on a comprehensive list of eligible procedures, based on a priori criteria, independent of local practices. We propose an algorithmic method, using only routinely available hospital data to identify surgical hospitalizations that could have been performed as one day treatment.MethodsMoving inpatient surgery to one day surgery was considered feasible if at least one surgical intervention was eligible for one day surgery and if none of the following criteria were present: intervention or affection requiring an inpatient stay, patient transferred or died, and length of stay greater than four days. The eligibility of a procedure to be treated as a day case was mainly established on three a priori criteria: surgical access (endoscopic or not), the invasiveness of the procedure and the size of the operated organ. Few overrides of these criteria occurred when procedures were associated with risk of immediate complications, slow physiological recovery or pain treatment requiring hospital infrastructure. The algorithm was applied to a random sample of one million inpatient US stays and more than 600 thousand Swiss inpatient stays, in the year 2002.ResultsThe validity of our method was demonstrated by the few discrepancies between the a priori criteria based list of eligible procedures, and a state list used for reimbursement purposes, the low proportion of hospitalizations eligible for one day care found in the US sample (4.9 versus 19.4% in the Swiss sample), and the distribution of the elective procedures found eligible in Swiss hospitals, well supported by the literature. There were large variations of the proportion of candidates for one day surgery among elective surgical hospitalizations between Swiss hospitals (3 to 45.3%).ConclusionThe proposed approach allows the monitoring of the proportion of inpatient stay candidates for one day surgery. It could be used for infrastructure planning, resources negotiation and the surveillance of appropriate resource utilization. |
| Databáze: | OpenAIRE |
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