Hospital Admissions of Ambulatory Surgical Patients / 대한마취과학회지

BACKGROUND: The purpose of ambulatory facilities is to relieve the pressure on hospital beds and to make the process of surgery more convenient for the patient. One way of assessing the success of a ambulatory unit is to look at the number of patients requiring admission to hospital. Thus the author investigated the rate, distribution, and cause of admission cases to get help to reduce the admission rates. METHODS: Total ambulatory surgeries were 15,512 cases for the period from March 1995 to January 1998. The medical records were reviewed and the patients admitted to hospital instead of being discharged home were analyzed retrospectively. RESULTS: The overall mean rates of admissions for the period was 0.76 percent. The principal reasons for admissions were requestion by surgeon (0.53%), wish of patients (0.12%), surgery related admissions (0.08%) and anesthesia related admissions (0.03%), respectively. CONCLUSIONS: With proper assessment and selection of patients and surgical procedures, the admission rates of ambulatory surgery will be reduced acceptably low. Thus the efficiency of ambulatory unit will be increased. But it will reduce the use rate of ambulatory unit. For increasing the use rate of ambulatory unit, our hospital is broadening the patients' selection criteria.

An Experience in Anesthesia for Ambulatory Surgery / 대한마취과학회지

BACKGROUND: Ambulatory surgery has the advantages of reduced demand for postoperative medications, faster recuperation, less disruption to personal life and reduced hospital costs. At present, 60-70% of surgery in North America is performed on an ambulatory basis. DSC (day-surgery center) was opened on March 1995 in our hospital. We want to introduce an experience in anesthesia for ambulatory surgery. METHODS: Ambulatory surgeries were reviewed from March 1995 to July 1996. Total ambulatory surgeries were 5,593 cases. The medical records of 1,816 patients who were anethetized by anesthesiologists for ambulatory surgery were an alyzed retrospectively (3,777 patients who were operated under local anesthesia were excluded). RESULTS: The rate of utility was 14.1% on March 1995 and 27.7% on January 1996. The mean rate of utility was 22.2% per month in DSC. The overall mean rate of delayed discharge for the period was 2.9% and the overall mean rate of admission for the period was 1.9%. The principal reasons for the both were requestion by surgeons without surgery and anesthesia-related complications. CONCLUSIONS: The increase of demands of patients for ambulatory surgeries, new technological developements for surgery and anesthesia and increased experiences of surgeons will stimulate the utility of day surgery center.