Historical Development and Experience of Day Surgery in China: From the Perspective of Anesthesiologists

Abstract

Background: Day surgery has become the main mode of surgery in American and European countries, but it is still in the early stage in developing countries due to the limitation of medical technology and the backward management concept. At present, day surgery accounts for more than 60% of elective surgery in many countries in Europe and North America and more than 85% in countries such as the United Kingdom and the United States. There are 8469 ambulatory surgery centers in the United States in 2023. In China, the first ambulatory surgery center was established in 2001. In 2018, more than half of the tertiary hospitals (high-level hospitals) in China carried out day surgery, of which 639 hospitals set up ambulatory surgery centers; the proportion of day surgery in elective surgery increased to 12.8%. The annual number of day surgeries exceeded 1.25 million. In 2022, our hospital established an ambulatory surgery center managed by anesthesiologists. Day surgery requires anesthesiologists to participate in the whole process of patient management from preoperative preparation to postoperative recovery. The establishment of ambulatory surgery centers managed by anesthesiologists is of great significance to China, developing countries, and the whole world.

Objectives: So this study aimed to review the development of day surgery in China, combine Chinese government policy evolution, summarize the management model of Chinese ambulatory surgery centers, guide the establishment of ambulatory surgery centers in low- and middle-income countries, and highlight and analyze the advantages of anesthesiologist-managed ambulatory surgery centers as distinct from other physician-managed ones.

Discussion: We call on anesthesiologists, other physicians, surgeons, nurses, and health system managers around the world to promote efficient, low-cost day surgery in developing countries and thereby increase access to surgical treatment for the world's poor.

Keywords: China; ambulatory surgery center; anesthesiologists; day surgery; historical development; management model.

FIGURE 1

Important time nodes in the development of DS in China. ASC, ambulatory surgery center; DS, day surgery.

FIGURE 2

Different management models and their managers. DS, day surgery; ASC, ambulatory surgery center.