The clinical and economic effects of early return to work after elective inguinal hernia repair

Abstract

Since 1 January 1976 male patients of four consultant surgeons undergoing elective repair of a unilateral inguinal hernia have been included in a trial to see if 'early' return to work or normal activity is associated with an increased recurrence rate and also to investigate any economic consequences. To date 295 patients have been entered into the trial and the first 150 have been reviewed at 1 year. There was a complete follow-up at 1 year. There was 1 recurrence (0.7 per cent) at 1 year, and this had occurred by the time the patient came to the clinic to be included in the trial. Patients supervised by their general practitioner were off work for 78.5 days, while those advised to return to work early were off work for 52.1 days. This difference of 25.4 days is significant at the 0.1 per cent level. Loss of earnings while off work was reported by 36.7 per cent of patients, and the average sum lost was 19.86 per week. Thus, patients lost 72.06 on average. If patients went back to work at 52 days instead of at 78 days, the benefit to the economy would be of the order of 7 m., and this 'early' return to work is not associated with an increase in the recurrence rate at 1 year.