[Evaluation of a day surgery unit].
OBJECTIVE
To evaluate the Day Surgery Unit (DSU) of the Medical Union of Uruguay Health Center (MUUHC), in Montevideo. The DSU is located in the MUUHC's Sanatorium 1 hospital, a 107-bed hospital that had previously handled low- and medium-complexity surgeries. The results of the reorganization of the surgical activity were analyzed in terms of service utilization, costs, and patient satisfaction.


METHODS
For four surgical specialties that were selected for study, health care data were gathered and used to determine the coverage level with the new approach, the number of days of hospitalization, the costs before and after putting the DSU into place, and the patients' opinions of the quality of the care.


RESULTS
For the 1998-1999 period, which was the second full year of operation of the DSU, the DSU was carrying out more than a third of the surgeries of the four surgical specialties being studied. These four specialties accounted for 84% of the total number of surgeries carried out by the DSU in the 1998-1999 period. The total number of days of hospitalization declined by 26%. The cost-effectiveness analysis showed that the conventional approach, with hospitalization, would have cost some two and a half times as much as the day surgery approach for the same surgeries. In general, the patients expressed strong satisfaction with the services they received from the DSU.


CONCLUSIONS
Our results indicate that it is definitively possible to recommend this day surgery form of care, since it provides good quality of care, it satisfies patients, and it dramatically lessens costs, thanks to the reduction in hospitalizations and the resources needed for inpatient services. It may be possible to expand this new regimen by including other conditions and surgical techniques that are appropriate for day surgeries.
Chirigliano
Gilda Verónica
GV
Centro de Asistencia del Sindicato Médico del Uruguay (CASMU), Montevideo, Uruguay.
Noceti
María Cristina
MC
D000556:Ambulatory Surgical Procedures / Q000191:economics* / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D006302:Health Services Research / Q000191:economics* / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D009885:Ophthalmology / Q000191:economics / Q000706:statistics & numerical data; D013517:Otorhinolaryngologic Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000191:economics / Q000706:statistics & numerical data; D013518:Surgery, Plastic / Q000191:economics / Q000706:statistics & numerical data; D014583:Uruguay