Abstract Background Day surgery is a cost-effective approach that minimizes hospital stays and enhances patient recovery. However, unplanned admissions after day surgery can increase hospital costs and complicate patient care. The Getting It Right First Time (GIRFT) initiative promotes the optimization of surgical practices by providing guidelines to mitigate factors such as unplanned admissions. Methods A retrospective audit conducted between January 2022 and January 2023 identified all unplanned admissions for three procedures: Inguinal hernia repairs, laparoscopic cholecystectomies and para umbilical hernia repairs. A cost analysis was performed comparing the median costs of day case discharges (n=6) vs unplanned admissions(n=6). Results Inguinal Hernia Repairs: 12% (18/152) were found to be unplanned admissions. The median cost of which was £3,086, compared to £3,339.5 in day case discharges, reflecting a slight 8.2% decrease in costs. However, Day case discharges exhibited more predictable costs, while unplanned admissions had a much broader variability. Laparoscopic Cholecystectomies: 22% (51/282) were unplanned admissions. The median cost for unplanned admissions was £7,652, compared to £3,876 for day case discharges, indicating an increase in costs by 49.3%. Paraumbilical Hernia Repairs: 14.5% (7/55) were unplanned admissions. The median cost being £3,146, compared to £1,610.5 for day case discharges, showing a stark increase of costs by 70.2%. Conclusion: Unplanned admissions in day surgery result in substantial cost increases, which could be mitigated by adhering to the GIRFT guidelines. Prioritizing day case surgeries (same-day discharges), where clinically appropriate, and improving pre-operative assessments, and discharge pathways could reduce unplanned admissions, leading to improved financial efficiency.
Ponnuswamy et al. (Fri,) studied this question.