General surgery with a special interest in vascular surgery: an audit of relative workload.
In a district general hospital (DGH) almost all vascular surgery is provided by general surgeons with a vascular interest and training. There is a growing view, however, that vascular surgeons should be 'pure' to the exclusion of other surgery. In an attempt to define the relationship between general and vascular work in a DGH we have analysed, prospectively, out-patient, in-patient and theatre workload over a three-month period. Eight-hundred-and-forty-four patients (277 new, 567 follow-up) were seen in the clinics. Nine per cent of new vascular referrals and 33 per cent of new general referrals were booked for admission. There were 356 admissions (50 per cent 'emergencies') representing a wide spectrum of general surgery. Elective and emergency vascular cases stayed in hospital for twice and four times longer, respectively, than general patients. Vascular patients represented 26 per cent of the caseload but accounted for 46 per cent of the bed occupancy. Vascular operations made up only 21 per cent of the total theatre caseload (233 procedures) but consumed 34 per cent of theatre time. The vascular unit in a DGH deals with a substantial number and wide variety of general surgical cases. Vascular surgery, however, consumes disproportionately large amounts of out-patient and theatre time and hospital beds. This has implications both for the planning of vascular services and also for the resource allocation within the hospital.
Department of Surgery, Royal Berkshire Hospital.
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Jaffe
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Chadwick
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Tomkins
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Galland
D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D004630:Emergencies; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D006113:United Kingdom; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data*; D000078329:Workforce; D016526:Workload