Abstract

CAMPOS CASTILLO, Carlos; HURTADO LOPEZ, Luis Mauricio; BASURTO KUBA, Erich  and  ZALDIVAR RAMIREZ, Rafael. Short stay surgery on weekends and holidays, experience at the General Surgery Service of the General Hospital of Mexico, O.D. Cir. gen [online]. 2012, vol.34, n.2, pp.130-133. ISSN 1405-0099.

Objective: To demonstrate the benefits of the impact, time, and cost-effectiveness of short stay surgery performed on weekends and holidays. Setting: General Hospital of Mexico (Third level health care hospital). Design: Prospective, cross-sectional, observational, and comparative study. Statistical analysis: Student's t test, chi square, and cost-effectiveness analysis. Material and method: During 4 years, 1,200 surgeries were performed within this pilot program, using the installed hospital infrastructure and the same personnel employed for medical care in those days, without having a special short stay surgery unit as such. Performed procedures were: inguinal plasty, resection of pilonidal disease, umbilical plasty, resection of benign soft tissue tumor, wall plasty, subcutaneous mastectomy, hemorrhoidectomy, fistulectomy, and excision of benign breast tumors, these were compared with the same procedures but performed as programmed surgeries. We assessed and compared the following variables: age, gender, performed procedure, time of hospital stay, and cost-benefit of the procedure. We also evaluated the need of hospitalization, re-admittance in less than 24 h, morbidity and mortality. Results: Diagnoses included: inguinal hernias with 486 cases, 359 cases of soft tissue tumors, 185 cases of umbilical hernia, 88 cases of eventration, 22 cases of anorectal disease, 17 cases of pilonidal disease, 17 cases of gynecomastia, 10 cases of phimosis, and 11 other diagnoses. We performed inguinal plasties, resection of pilonidal disease, umbilical plasty, excision of soft tissue tumor, wall plasty, subcutaneous mastectomy, hemorrhoidectomy and/or fistulectomy, circumcision and other procedures. The time used for surgical management was reduced from an average of 36 to 12 hours (p < 0.05). Cost-effectiveness was 40% lower as compared with the traditional method. Surgical and anesthetic times were not different between ambulatory and traditional surgeries. Conclusion: Short stay surgery can be performed efficiently on the weekends and holydays with a 40% savings.

Keywords : Surgery; short stay surgery; cost-effectiveness.

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