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A policy of day-case sinonasal surgery is safe, well tolerated and cost-effective

Published online by Cambridge University Press:  26 March 2021

M Duignan
Affiliation:
Department of Otolaryngology, Waikato Hospital, Hamilton, New Zealand
C Lao
Affiliation:
Waikato Medical Research Centre, Waikato University, Hamilton, New Zealand
R Lawrenson
Affiliation:
Waikato Medical Research Centre, Waikato University, Hamilton, New Zealand Strategy and Funding, Waikato District Health Board, Hamilton, New Zealand
A J Wood*
Affiliation:
Department of Otolaryngology, Waikato Hospital, Hamilton, New Zealand Waikato Clinical Campus, University of Auckland, New Zealand Waikato Institute of Surgical Education and Research, Hamilton, New Zealand
*
Author for correspondence: Dr Andrew Wood, Waikato Clinical Campus, University of Auckland, Auckland, New Zealand Email: andrew.wood@auckland.ac.nz

Abstract

Objective

Practices vary regarding the timing of discharge after sinonasal surgery. This study aimed to examine the cost-effectiveness of same-day discharge compared to next-day discharge after sinonasal surgery.

Methods

A retrospective single-surgeon audit of sinonasal surgery over a 12-month period was performed. Demographic and clinical details, including distance travelled home, timing of discharge, hospital re-presentation, and complications, were collected and compared between the same-day discharge and next-day discharge groups. A cost-effectiveness analysis was performed.

Results

A total of 181 patients were identified; 117 underwent day-case surgery, of which 6 re-presented to the emergency department. Sixty-four patients stayed overnight after surgery, and six of those patients re-presented to the emergency department. The per patient cost was $3262 for day-case sinonasal surgery and $5050 for those admitted overnight after surgery (p < 0.001).

Conclusion

Routine same-day discharge after sinonasal surgery is achievable, safe and cost-effective.

Type
Main Articles
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr A Wood takes responsibility for the integrity of the content of the paper

References

Munnich, E, Parente, S. Procedures take less time at ambulatory surgery centers, keeping costs down and ability to meet demand up. Health Aff (Millwood) 2014;33:764–9CrossRefGoogle ScholarPubMed
Patel, A, Reber, P, Ghosh, S. Patient satisfaction and postoperative demands on hospital and community services after day surgery. Br J Surg 1995;82:714–15CrossRefGoogle ScholarPubMed
Bhattacharyya, N. Incremental health care utilization and expenditures for chronic rhinosinusitis in the United States. Ann Otol Rhinol Laryngol 2011;120:423–7CrossRefGoogle ScholarPubMed
Hopkins, C, Browne, J, Slack, R, Brown, P. Variation in day-case nasal surgery - why cannot we improve our day-case rates? Clin Otolaryngol 2007;32:1218CrossRefGoogle ScholarPubMed
Hogg, R, Prior, M, Johnson, A. Admission rates, early readmission rates and patient acceptability of 142 cases of day case septoplasty. Clin Otolaryngol Allied Sci 1999;24:213–15CrossRefGoogle ScholarPubMed
Ganesan, S, Prior, A, Rubin, J. Unexpected overnight admissions following day-case surgery: an analysis of a dedicated ENT day care unit. Ann R Coll Surg Engl 2000;82:327–30Google ScholarPubMed
Singh, G, McCormack, D, Roberts, D. Readmission and overstay after day case nasal surgery. BMC Ear Nose Throat Disord 2004;4:2CrossRefGoogle ScholarPubMed
Dalziel, K, Stein, K, Round, A, Garside, R, Royle, P. Endoscopic sinus surgery for the excision of nasal polyps: a systematic review of safety and effectiveness. Am J Rhinol 2006;20:506–19CrossRefGoogle Scholar
Bajaj, Y, Sethi, N, Carr, S, Knight, L. Endoscopic sinus surgery as day-case procedure. J Laryngol Otol 2009;123:619–22CrossRefGoogle ScholarPubMed
Zaman, S, Faraz, Q, Adeel, M, Suhail, A, Aqil, S. Readmissions after day care surgery in ENT: a tertiary care experience. J Ayub Med Coll Abbottabad 2019;31:185–8Google ScholarPubMed
Agha, R, Heaton, S, Roberts, D. Patient satisfaction with day-case septoplasty and septorhinoplasty. J One-Day Surg 2003;14:22–5Google Scholar
Hastan, D, Fokkens, W, Bachert, C, Newson, R, Bislimovska, J, Bockelbrink, A et al. Chronic rhinosinusitis in Europe--an underestimated disease. A GA2LEN study. Allergy 2011;66:1216–23CrossRefGoogle Scholar
Brożek, JL, Bousquet, J, Agache, I, Agarwal, A, Bachert, C, Bosnic-Anticevich, S et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines - 2016 revision. J Allergy Clin Immunol 2017;140:950–8CrossRefGoogle ScholarPubMed
Bhattacharyya, N, Orlandi, R, Grebner, J, Martinson, M. Cost of burden of chronic rhinosinusitis: a claims-based study. Otolaryngol Head Neck Surg 2011;144:440–5CrossRefGoogle ScholarPubMed
Pézier, T, Stimpson, P, Kanegaonkar, R, Bowdler, D. Ear, nose and throat day-case surgery at a district general hospital. Ann R Coll Surg Engl 2009;91:147–51CrossRefGoogle Scholar
Rudkin, G, Bacon, A, Burrow, B, Chapman, M, Claxton, M, Donovan, B et al. Review of efficiencies and patient satisfaction in Australian and New Zealand day surgery units: a pilot study. Anaesth Intensive Care 1996;24:74–8CrossRefGoogle ScholarPubMed
Bhattacharyya, N. Ambulatory sinus and nasal surgery in the United States: demographics and perioperative outcomes. Laryngoscope 2010;120:635–8CrossRefGoogle ScholarPubMed
Bhattacharyya, N. Unplanned revisits and readmissions after ambulatory sinonasal surgery. Laryngoscope 2014;124:1983–7CrossRefGoogle ScholarPubMed