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Admission-discharge policies for hysteroscopic surgery: a randomised comparison of day case with in-patient admission.

Author information

1
Department of Obstetrics and Gynaecology, Aberdeen Royal Infirmary, UK.

Abstract

OBJECTIVE:

To study the effectiveness and acceptability of day case hysteroscopic surgery.

DESIGN:

Prospective randomised controlled trial.

SETTING:

Aberdeen Royal Infirmary.

SUBJECTS:

One hundred and ninety four consecutive women who underwent hysteroscopic endometrial ablation.

INTERVENTION:

Seventy three women were allocated to day case surgery and 37 to inpatient admission; 84 women though otherwise fit for day case surgery were scheduled for in-patient admission as they lived more than 20 miles away. All women completed a questionnaire 24 h after their operations. Readmission rates were obtained from case notes. Satisfaction rates 12 months after the operation were recorded by means of a follow-up questionnaire.

RESULTS:

Post-operative pain was absent or slight in 48 (75%) of the women in the day case group 27 (84%) of women in the in-patient group, and 55 (82%) in the non-randomised in-patient group. Post-operative analgesia was necessary in 34 (52%) women in the day case group, 24 (75%) women in the in-patient group and 36 (53%) women in the non-randomised in-patient group. Hospital costs were significantly less in the day case group. Satisfaction with stay 92% in the day case group, and 100% in the other two groups.

CONCLUSION:

In this setting, day care is a safe acceptable and less expensive alternative to in-patient care for hysteroscopic endometrial ablation.

PMID:
9481553
DOI:
10.1016/s0301-2115(97)00140-1
[Indexed for MEDLINE]

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