Complications after discharge for surgical patients.
OBJECTIVE
To measure the type and frequency of complications for surgical patients 1 month after discharge.


METHODS
A post-discharge patient survey was conducted in 2000 for patients who had undergone one of five elective operations: transurethral resection of the prostate, hysterectomy, major joint replacement, cholecystectomy, herniorrhaphy. Two hundred and fourteen patients (74%) returned the survey forms, which were sent 1 month after surgery. Patients were recruited from two teaching hospitals in the Hunter Area Health Service, New South Wales, Australia.


RESULTS
One hundred and thirty-five (63%) patients reported one or more complications and 78 (37%) received treatment for 109 complications. Eighty-six per cent reported pain after discharge and 41% reported moderate to severe pain. Seventeen per cent reported infections after discharge and 94% of these patients were given treatment. Twenty-eight per cent reported bleeding after discharge and 20% of these were given treatment. Eleven (5%) patients were readmitted for treatment of problems related to their surgery including four who required further surgery. One hundred and seventy-two patients accessed a range of health services during the first month after discharge, resulting in 266 occasions of service. Twenty-eight per cent of post-discharge services were unplanned.


CONCLUSIONS
The lack of post-discharge monitoring conceals information about surgical outcomes. Patient reporting is an effective method of monitoring post-discharge outcomes. There is scope to develop post-discharge services to improve the quality of care in the areas of post-discharge pain management, the use of prophylactic measures and to provide treatment for complications that occur during this period.
The University of Newcastle, Newcastle, New South Wales, Australia.
Ashley
A
Kable
Robert
R
Gibberd
Allan
A
Spigelman
D019643:Arthroplasty, Replacement; D002763:Cholecystectomy; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data*; D006547:Hernia; D006801:Humans; D007044:Hysterectomy; D008297:Male; D010349:Patient Compliance; D010351:Patient Discharge; D011183:Postoperative Complications; D013997:Time Factors; D020728:Transurethral Resection of Prostate