Same-Day Discharge Metabolic-Bariatric Surgery in Australia: Experience in a Regional Public Hospital

Abstract

Background: Access to publicly funded bariatric surgery (MBS) remains suboptimal across Australia and New Zealand. The COVID-19 pandemic placed additional stress on the public healthcare system, and as a result, overnight beds in public hospitals have become a premium commodity. Same-day discharge (SDD) MBS has been shown to enhance efficiency and reduce costs in Europe and the United States. This study aims to evaluate the safety and clinical outcomes of implementing SDD MBS in a public regional hospital in Australia.

Methods: A retrospective analysis was conducted using a prospectively maintained database of patients who underwent SDD MBS at Wagga Wagga Base Hospital between December 2018 and September 2024. Patient selection followed strict inclusion criteria and a multidisciplinary approach. Standardised perioperative protocols were applied, with virtual follow-up at 24-48 h and outpatient intravenous hydration provided if needed. Outcomes included successful SDD rates, 30-day readmissions, complications, and mortality.

Results: Thirty-eight patients underwent MBS with intended SDD. Thirty-five (92.1%) were successfully discharged on the same day. Three (7.9%) patients required overnight hospitalisation. The 30-day readmission rate was 2.9% (n = 1/35), with no postoperative complications or mortality recorded. Outpatient intravenous hydration was required in 11.4% (n = 4/35) of cases. Laparoscopic sleeve gastrectomy was the most common procedure (68.4%).

Conclusion: This study demonstrates that SDD MBS is a safe and effective pathway in selected patients, with low readmission and complication rates. Implementing SDD in the public sector has the potential to improve access to bariatric services, reduce healthcare costs, and optimise resource utilisation.