Day-case surgery for hernias and haemorrhoids. A clinical, social, and economic evaluation

Abstract

Patients with inguinal hernia or haemorrhoids were randomly allocated to an experimental group expected to stay in hospital for only eight hours after surgery or a control group scheduled for discharge on the fifth or sixth day. There was no difference in clinical outcome between the two groups of hernia patients. However, complications were twice as common in haemorrhoid day-patients as in long-stay haemorhoid patients. The standard postoperative regimen for haemorrhoids has since been changed and the change has been accompanied by a fall in the complication-rate. Day-case surgery appears to have similar social effects on the patient and his family as traditional hospital care. There was no significant difference in either the additional expenditure incurred or patients' perceptions of the disruption associated with their operation and convalescence. In the hospital under study, day-case surgery was saving between 20 pounds and 29 pounds per patient. However, this conclusion should not be extrapolated to the N.H.S. as a whole without taking into account the use to which the resources released by day-case surgery will be put.