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, 王振軍.日間手術的概念和基本問題.中國實用外科雜志, 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.	國永生, 張忠濤.腹股溝疝無張力修補日間手術516例報告.臨床外科雜志, 2007, 15(2):139-140.
4.	郝美玲.日間手術的發展和麻醉.齊齊哈爾醫學院學報, 2010, 31(6):1006-1007.
5.	邵新華, 方朕, 楊炯, 等.關于開展日間手術的實踐和探討.中國醫院, 2010, 14(12):36-38.
6.	國永生.腹股溝疝日間手術經驗和注意事項.臨床外科雜志, 2010, 18(3):155-156.
7.	秦勝旗, 張忠濤, 王宇.腹股溝疝、股疝的無張力修補技術在日間手術的應用.國際外科學雜志, 2009, 36(7):499-501.
8.	鄭樹忠.關于衛生事業發展與費用控制的探討.中國衛生資源, 2000, 3(5):203-205.
9.	中華醫學會外科學分會疝和腹壁外科學組.成人腹股溝疝、股疝和腹部手術切口疝手術治療方案(2003年修訂稿).中華外科雜志, 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.	劉素蘭.結合疝外科手術淺談日間手術室的管理與前景.中華疝和腹壁外科雜志:電子版, 2009, 3(1):60-61.
13.	Stephenson BM. Complications of open groin hernia repairs. Surg Clin North Am, 2003, 83(5):1255-1278.
14.	黃建, 劉永強, 謝偉, 等.局部和硬膜外麻醉方式下腹股溝疝無張力修補術的衛生經濟學評價.中華疝和腹壁外科雜志:電子版, 2010, 4(1):48-51.
15.	馮波, 夏怡, 陸愛國, 等.腹腔鏡與開腹直腸前切除術的衛生經濟學評價.外科理論與實踐, 2006, 11(5):389-392.

1. ?安燚, 王振軍.日間手術的概念和基本問題.中國實用外科雜志, 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. 國永生, 張忠濤.腹股溝疝無張力修補日間手術516例報告.臨床外科雜志, 2007, 15(2):139-140.
4. 郝美玲.日間手術的發展和麻醉.齊齊哈爾醫學院學報, 2010, 31(6):1006-1007.
5. 邵新華, 方朕, 楊炯, 等.關于開展日間手術的實踐和探討.中國醫院, 2010, 14(12):36-38.
6. 國永生.腹股溝疝日間手術經驗和注意事項.臨床外科雜志, 2010, 18(3):155-156.
7. 秦勝旗, 張忠濤, 王宇.腹股溝疝、股疝的無張力修補技術在日間手術的應用.國際外科學雜志, 2009, 36(7):499-501.
8. 鄭樹忠.關于衛生事業發展與費用控制的探討.中國衛生資源, 2000, 3(5):203-205.
9. 中華醫學會外科學分會疝和腹壁外科學組.成人腹股溝疝、股疝和腹部手術切口疝手術治療方案(2003年修訂稿).中華外科雜志, 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. 劉素蘭.結合疝外科手術淺談日間手術室的管理與前景.中華疝和腹壁外科雜志:電子版, 2009, 3(1):60-61.
13. Stephenson BM. Complications of open groin hernia repairs. Surg Clin North Am, 2003, 83(5):1255-1278.
14. 黃建, 劉永強, 謝偉, 等.局部和硬膜外麻醉方式下腹股溝疝無張力修補術的衛生經濟學評價.中華疝和腹壁外科雜志:電子版, 2010, 4(1):48-51.
15. 馮波, 夏怡, 陸愛國, 等.腹腔鏡與開腹直腸前切除術的衛生經濟學評價.外科理論與實踐, 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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