© 1992 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom
research-article |
Surgeons' views of day surgery: is there a consensus among providers?
Myfanwy Morgan, Senior Lecturer
R. Beech, Research Fellow
Angela Reynolds, Research Assistant
A. V. Swan, Reader
H. B. Devlin, Consultant Surgeon
Department of Public Health Medicine, United Medical and Dental Schools, St Thomas' Hospital London SE1 7EH
Surgical Audit Unit, Royal College of Surgeons of England, Lincolns Inn Fields London WC2A 3PN
Address correspondence to M. Morgan
Managers and purchasers of health services are being encouraged to expand day surgery as a means of providing high-quality care and reducing costs per case and waiting times. This study examined general surgeons' views of day surgery with particular reference to day case inguinal hernia repair. A postal questionnaire was completed by 240 consultants (85 per cent) in four Regional Health Authorities. Only 11 per cent were regularly undertaking day case inguinal hernia repair, a further 44 per cent held positive attitudes towards this form of treatment and 45 per cent were not interested, with attitudes varying by age and region. Major constraints perceived by those with positive attitudes were the lack of facilities at a hospital level and problems of community services. Negative attitudes were associated with concerns about post-operative complications and pain, and assumptions about patients' preferences. This demonstrates a considerable range in surgeons' attitudes to day surgery despite its formal endorsement by professional bodies, and identifies what are perceived as the organizational and clinical barriers to its wider introduction. It is suggested that eliciting provider views and concerns forms an important requirement for the successful implementation of organizational change.