Cost-Effectiveness Analysis of Day Surgery Versus Inpatient Surgery for Tension-Free Herniorrhaphy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 GONGyan-ping ,  LEIWen-zhang , SONGYing-han , BANLi-jie

Department of General Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

LEIWen-zhang, Email: 22822444@qq.com

Keywords：

Tension-free herniorrhaphy; Day surgery; Inpatient surgery; Economics evaluation; Randomized controlled trial

DOI：

10.7507/1007-9424.20150177

Video：

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Objective To explore the surgical effect and cost-effectiveness of day surgery versus inpatient surgery for tension-free herniorrhaphy. Methods A total of 100 cases of unilateral inguinal hernia who treated in West China Hospital of Sichuan University from Jan. 2010 to Sep. 2010 were collected prospectively, and were randomly divided into 2 groups: day surgery group (50 cases) and inpatient surgery group (50 cases). Comparison of the surgical effect and cost-effectiveness of day surgery versus inpatient surgery was performed. Results There was no significant difference in the operation time, blood loss during the operation, incidence of urinary retention, scrotal edema fluid, incision foreign body sensation, and total complications, the time of get out of bed after surgery, and the time of returning to work after surgery (P > 0.05), but the hospital stay of day surgery group was shorter than that of inpatient surgery group (P < 0.05). The total cost of day surgery group was lower than that of inpatient surgery group (P < 0.05). There was no significant difference in the preoperation cost and introperative cost (P > 0.05), but the postoperative cost of day surgery group was lower than that of inpatient surgery group (P < 0.05). In the preoperation cost, there was no significant difference in the intraoperative monitoring fee, anesthesia and surgery materials fee, and drug charges (P > 0.05), but in the postoperative cost, the drug charges, nursing care fee, bed fee, and escort fee of day surgery group were all lower than that of inpatient surgery group (P < 0.05). Conclusions The effect of day surgery for tension-free herniorrhaphy is similar with inpatient surgery. But compared with inpatient surgery, the total cost of day surgery is lower, turn-over rate is higher, so it improves utilization of medical resources, reduces economic burden, and also reduces the medical burden of the country.

Citation： GONGyan-ping, LEIWen-zhang, SONGYing-han, BANLi-jie. Cost-Effectiveness Analysis of Day Surgery Versus Inpatient Surgery for Tension-Free Herniorrhaphy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(6): 688-691. doi: 10.7507/1007-9424.20150177 Copy

1.	安燚, 王振军.日间手术的概念和基本问题.中国实用外科杂志, 2007, 27(1):38-40.
2.	Karen A, Margaret J, Golosinskiy A, et al. Ambulatory surgery in the United States, 2006. Natl Health Stat Report, 2009, 11(28):1-28.
3.	国永生, 张忠涛.腹股沟疝无张力修补日间手术516例报告.临床外科杂志, 2007, 15(2):139-140.
4.	郝美玲.日间手术的发展和麻醉.齐齐哈尔医学院学报, 2010, 31(6):1006-1007.
5.	邵新华, 方朕, 杨炯, 等.关于开展日间手术的实践和探讨.中国医院, 2010, 14(12):36-38.
6.	国永生.腹股沟疝日间手术经验和注意事项.临床外科杂志, 2010, 18(3):155-156.
7.	秦胜旗, 张忠涛, 王宇.腹股沟疝、股疝的无张力修补技术在日间手术的应用.国际外科学杂志, 2009, 36(7):499-501.
8.	郑树忠.关于卫生事业发展与费用控制的探讨.中国卫生资源, 2000, 3(5):203-205.
9.	中华医学会外科学分会疝和腹壁外科学组.成人腹股沟疝、股疝和腹部手术切口疝手术治疗方案(2003年修订稿).中华外科杂志, 2004, 42(14):834-835.
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11.	Toftgaard C, Parmentier G. International terminology in ambulatory surgery and its worldwide practice. Lemos p, Jarrett PEM, Philip B. Day surgery-development and practice. London:International Association for Ambulatory Surgery, 2006:35-60.
12.	刘素兰.结合疝外科手术浅谈日间手术室的管理与前景.中华疝和腹壁外科杂志:电子版, 2009, 3(1):60-61.
13.	Stephenson BM. Complications of open groin hernia repairs. Surg Clin North Am, 2003, 83(5):1255-1278.
14.	黄建, 刘永强, 谢伟, 等.局部和硬膜外麻醉方式下腹股沟疝无张力修补术的卫生经济学评价.中华疝和腹壁外科杂志:电子版, 2010, 4(1):48-51.
15.	冯波, 夏怡, 陆爱国, 等.腹腔镜与开腹直肠前切除术的卫生经济学评价.外科理论与实践, 2006, 11(5):389-392.

1. 安燚, 王振军.日间手术的概念和基本问题.中国实用外科杂志, 2007, 27(1):38-40.
2. Karen A, Margaret J, Golosinskiy A, et al. Ambulatory surgery in the United States, 2006. Natl Health Stat Report, 2009, 11(28):1-28.
3. 国永生, 张忠涛.腹股沟疝无张力修补日间手术516例报告.临床外科杂志, 2007, 15(2):139-140.
4. 郝美玲.日间手术的发展和麻醉.齐齐哈尔医学院学报, 2010, 31(6):1006-1007.
5. 邵新华, 方朕, 杨炯, 等.关于开展日间手术的实践和探讨.中国医院, 2010, 14(12):36-38.
6. 国永生.腹股沟疝日间手术经验和注意事项.临床外科杂志, 2010, 18(3):155-156.
7. 秦胜旗, 张忠涛, 王宇.腹股沟疝、股疝的无张力修补技术在日间手术的应用.国际外科学杂志, 2009, 36(7):499-501.
8. 郑树忠.关于卫生事业发展与费用控制的探讨.中国卫生资源, 2000, 3(5):203-205.
9. 中华医学会外科学分会疝和腹壁外科学组.成人腹股沟疝、股疝和腹部手术切口疝手术治疗方案(2003年修订稿).中华外科杂志, 2004, 42(14):834-835.
10. Aylin P, Williams S, Jarman B, et al. Trends in day surgery rates. BMJ, 2005, 331(7520):803.
11. Toftgaard C, Parmentier G. International terminology in ambulatory surgery and its worldwide practice. Lemos p, Jarrett PEM, Philip B. Day surgery-development and practice. London:International Association for Ambulatory Surgery, 2006:35-60.
12. 刘素兰.结合疝外科手术浅谈日间手术室的管理与前景.中华疝和腹壁外科杂志:电子版, 2009, 3(1):60-61.
13. Stephenson BM. Complications of open groin hernia repairs. Surg Clin North Am, 2003, 83(5):1255-1278.
14. 黄建, 刘永强, 谢伟, 等.局部和硬膜外麻醉方式下腹股沟疝无张力修补术的卫生经济学评价.中华疝和腹壁外科杂志:电子版, 2010, 4(1):48-51.
15. 冯波, 夏怡, 陆爱国, 等.腹腔镜与开腹直肠前切除术的卫生经济学评价.外科理论与实践, 2006, 11(5):389-392.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Cost-Effectiveness Analysis of Day Surgery Versus Inpatient Surgery for Tension-Free Herniorrhaphy

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