title: Improving appropriate use of surgical services.
abstract: The aspects of surgical services being addressed from the point of view of appropriateness in Australia at the present time are the use of the surgical bed, the maintenance of standards by the surgeon and the need for and outcome of the surgical procedures performed. There are growing waiting lists now for the 70% of acute hospital beds which are public. Whilst these waiting lists are inaccurate and require regular review their existence has led to a greater interest in reducing length of stay. This has hitherto not been of concern, with hernia patients for example staying five days or more. With regard to the surgeon it has been felt that the long training period (six years) guaranteed a high standard which was maintained. The Royal Australasian College of Surgeons is however, now to introduce a system of re-certification which will involve a demonstration of continuing education, the maintenance of an audit and a periodic physical examination. Delineation of privileges has until now only been in the broad traditional categories but consideration is being given to delineation of privileges for sophisticated surgery and particularly for new procedures (e.g. percutaneous cholecystectomy). Systems for assessing the quality of the surgery itself have been slow to develop, particularly in the smaller and private hospitals. Government bodies have been concerned in the private sphere with over servicing and a number of studies have been done showing regional variations in numbers of operations performed. Over servicing is, however, difficult to detect.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.forename: B T
authors.initials: BT
authors.lastname: Collopy
mesh_terms: D001315:Australia; D002568:Certification; D013502:General Surgery / Q000193:education*; D006300:Health Services Misuse; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D011785:Quality Assurance, Health Care; D013503:Surgery Department, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D014850:Waiting Lists