Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 30;12(7):1082.
doi: 10.3390/jpm12071082.

Qualitative Interview Study of Gynecologic Oncologist Utilization of Recommended Same-Day Discharge Following Minimally Invasive Hysterectomy

Sophia Bunde  1 , Shalkar Adambekov  2 , Ella Glikson  3 , Faina Linkov  1
Affiliations

Qualitative Interview Study of Gynecologic Oncologist Utilization of Recommended Same-Day Discharge Following Minimally Invasive Hysterectomy

Sophia Bunde et al. J Pers Med. .

Abstract

Recent investigations have supported the safety and benefits of discharging women on the same day following a minimally invasive hysterectomy (MIH) for both benign and malignant indications. Not all eligible candidates for same-day discharge (SDD) are discharged the same day, and patients undergoing an MIH for malignant indications have decreased the odds of receiving SDD despite established safety. The objective of this study was to use qualitative interviews to explore physician decision making regarding SDD after an MIH for malignant indications. Six qualitative interviews of gynecologic oncologists were analyzed using recurrent theme analysis for distinct themes in physician decision making regarding SDD. Results suggest that physician-perceived barriers to SDD include patient health characteristics, patient social characteristics, and hospital-system factors. Cited factors influencing SDD include patient travel, social support, practice setting (urban vs. rural) and staff comfort with the recommendation. Obstructive sleep apnea and post-surgical oxygenation appear to be a recurring reason for unplanned admission. The utilization of SDD after an MIH in the gynecologic oncology patient population is influenced by patient, physician, and system factors. Addressing the physician's perceived barriers to SDD and catering recommendations to the gynecologic oncology population may increase utilization.

Keywords: gynecologic oncology; hysterectomy; minimally invasive surgery; same-day discharge; value of care.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
The barriers to SDD identified by the interviewed physicians fall into three major categories: patient factors, provider factors, and system factors.
See this image and copyright information in PMC

References

    1. Moore B.J., Steiner C.A., Davis P.H., Stocks C., Barrett M.L. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Agency for Healthcare Research and Quality; Rockville, MD, USA: 2006. Trends in Hysterectomies and Oophorectomies in Hospital Inpatient and Ambulatory Settings, 2005–2013: Statistical Brief #214; pp. 1–17. - PubMed
    1. Committee on Gynecologic Practice. Committee Opinion No 701: Choosing the Route of Hysterectomy for Benign Disease. Obstet. Gynecol. 2017;29:e155–e159. doi: 10.1097/AOG.0000000000002112. - DOI - PubMed
    1. Sanei-Moghaddam A., Goughnour S., Edwards R., Comerci J., Kelley J., Donnellan N., Linkov F., Mansuria S. Hysterectomy Pathway as the Global Engine of Practice Change: Implications for Value in Care. Cent. Asian J. Glob. Health. 2017;6:299. doi: 10.5195/cajgh.2017.299. - DOI - PMC - PubMed
    1. Lee J., Aphinyanaphongs Y., Curtin J.P., Chern J.Y., Frey M.K., Boyd L.R. The safety of same-day discharge after laparoscopic hysterectomy for endometrial cancer. Gynecol. Oncol. 2016;142:508–513. doi: 10.1016/j.ygyno.2016.06.010. - DOI - PubMed
    1. Lee S.J., Calderon B., Gardner G.J., Mays A., Nolan S., Sonoda Y., Barakat R.R., Leitao M.M., Jr. The feasibility and safety of same-day discharge after robotic-assisted hysterectomy alone or with other procedures for benign and malignant indications. Gynecol. Oncol. 2014;133:552–555. doi: 10.1016/j.ygyno.2014.04.006. - DOI - PubMed

LinkOut - more resources