title: A review of the nature and activity of a general surgical service in Ireland.
abstract: The steady increase in hospital costs has led to demands for closer scrutiny of activity levels, workloads and outcomes. This study sought to examine these parameters in a typical district general surgical unit in this country. In the five year period 1985-89, 11,227 inpatient and 3,354 outpatient procedures were performed; 83% of the inpatient procedures were elective and 17% were emergency surgical operations. All inpatient procedures were categorized: minor (41%), intermediate (42%) and major (17%). A prospective one year review in 1990/1991 confirmed the accuracy of the retrospective data. During that year 2,335 inpatient operations and 765 outpatient operations were performed, of which 80.5% of the inpatient operations were elective and 19.5% were emergency procedures. Of these 16.6% were major, 34.4% intermediate and 49% were minor operations. 60% of the operations were performed by consultants. The in-hospital surgical mortality for the 1 year prospective review was 1.35% and the perioperative mortality was 0.64%. The overall operation morbidity rate was 9% and the procedure-related morbidity was 4.7%. The wound infection rate was 2%. Of the common operations performed throughout the six year study period appendicectomies and external hernia operations accounted for 20% of the caseload; 14% were urological, 7% were breast and 6% were biliary operations. The average waiting time for elective admissions was less than 4 weeks. The average length of hospital stay and the bed occupancy rates did not change.
authors.affiliation: Department of Surgery, International Missionary Training Hospital, Our Lady of Lourdes, Drogheda, Ireland.
authors.forename: J
authors.initials: J
authors.lastname: Lavelle
authors.forename: M G
authors.initials: MG
authors.lastname: Davies
authors.forename: J A
authors.initials: JA
authors.lastname: Connolly
authors.forename: E
authors.initials: E
authors.lastname: O'Broin
authors.forename: M F
authors.initials: MF
authors.lastname: Shine
authors.forename: F
authors.initials: F
authors.lastname: Lennon
mesh_terms: D013502:General Surgery; D017052:Hospital Mortality; D006801:Humans; D007494:Ireland; D009017:Morbidity; D011446:Prospective Studies; D012189:Retrospective Studies; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D016526:Workload