Day surgery: development of a national comparative audit service.
OBJECTIVE
To develop software for hospitals to analyse their own survey data on patients' experiences of day surgery and to create and test the feasibility of a national comparative audit service.


METHODS
Software development and testing; database analysis.


METHODS
Eleven general hospitals in England.


METHODS
1741 day surgery patients undergoing procedures during 1991-2.


METHODS
Postoperative symptoms, complications, health and functional status, general satisfaction, and satisfaction with specific aspects of care.


RESULTS
Software for data entry and analysis by hospitals was successfully used at the pilot sites. The overall response rate for the 11 hospitals using the questionnaire was 60%, ranging from 33% to 90% depending on the way the survey was managed. Data from all 11 hospitals were included in the national comparative audit database. Hospitals showed little variation in measures of patients' overall satisfaction (around 85%), but significant differences were apparent for specific aspects such as receiving adequate written information before admission (range 50%-89%), provision of adequate parking facilities (14%-92%) and experiencing a significant amount of postoperative pain (8%-42%). The proportion of day case patients undergoing procedures that could have been performed in outpatient departments varied from 0 to 27% between hospitals. Further comparisons of outcome, in particular measures of effectiveness, must await the development of validated case mix adjustment methods.


CONCLUSIONS
Establishing a comparative audit database is feasible but several methodological problems remain to be resolved.
Black
N
N
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine.
Petticrew
M
M
Hunter
D
D
Sanderson
C
C
D000556:Ambulatory Surgical Procedures / Q000592:standards*; D016208:Databases, Factual; D004739:England; D006302:Health Services Research; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D010045:Outpatients / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012107:Research Design; D012985:Software Design; D013222:State Medicine; D011795:Surveys and Questionnaires