International variations in availability and diffusion of alternatives to in-patient care in Europe: the case of day surgery

Abstract

International variations in availability and diffusion of alternatives to in-patient care in Europe Kroneman, Madelon W.; Westert, Gert P.; Groenewegen, Peter P.; Delnoij, Diane M.J. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. AbstractObjecti6es: Technological and medical developments have contributed to the increasing number of surgical procedures carried out as a day-case rather than an inpatient hospital setting. The diffusion of day surgery varies among European countries. This study aims at explaining this variation in healthcare system characteristics. Methods: Questionnaires were sent to experts in 12 countries in Northwest Europe. The questionnaire contained questions about the organization and diffusion of day case surgery (at country level and individually for 18 selected procedures), and relevant healthcare system characteristics (financing systems, organization of after care, etc.). Results: It is demonstrated that hospital bed supply relates to the diffusion of day surgery. In countries with fewer beds, a higher day surgery rate is found. The financing system of hospitals does not influence the choice of surgical setting. In countries with a fee-for-service financing system for hospital-based physicians, day surgery rates are not higher than in countries with salaried medical specialists. With respect to aftercare, the availability of sufficient home nurses favours day surgery. Conclusions: The relative scarcity of hospital beds or large reductions in bed supply has led to the perception of day surgery as an alternative that could meet the growing demand for surgical treatment. It is worthy of note that, although the majority of experts state that financial incentives discourage day surgery, the supply is growing.

Day surgery and hospital efficiency: empirical analysis of Norwegian hospitals, 1999–2001

“…Whereas patients earlier were admitted for a longer time and often also for relatively easy treatment procedures, cultural changes and changes in the conditions and organisation of aftercare have contributed to such a development [19]. In a European comparative perspective Norway thus ranks very high in terms of the diffusion of day surgery [9,20]. In order to study the effect of day surgery empirically, two important aspects need to be clarified.…”

Efficiency of day surgery in Slovak regions during the years 2009-2014

“…It is also necessary to take into consideration the level of operational invasiveness, the relevant complications, the risk of blood loss, the estimated post-operative pain or the time which is necessary to perform day surgery operations (Kroneman, 2001; Soltes et al, 2011a; Soltes & Gavurova, 2014) [4][5][6]. Threrefore, minimally invasive procedures, particularly in general surgery, represent a viable option (Soltes et al, 2010) [7].…”

Prise en charge ambulatoire de la promontofixation laparoscopique pour prolapsus génital

“…Puis, ce mode de prise en charge s'est développé dans plusieurs pays européens avec la Grande Bretagne comme pionnier dès les années 1970 et une croissance rapide à partir des années 1980 [1] (source Agence nationale de l'accréditation et de l'évaluation en santé [Anaes] « La chirurgie ambulatoire », Paris, 1997). Le retard de la France a été constaté par la Direction générale de l'offre de soins (DGOS) qui a saisi la Haute Autorité de santé (HAS) de façon à mener les travaux à conduire pour augmenter cette part d'activité chirurgicale (selon le document de la HAS -« Socle de connaissances » -avril 2012).…”