title: Cost-effective utilization of a private facility to perform outpatient surgery in public hospital waiting list patients.
abstract: BACKGROUND
  Public hospitals' long waiting lists make outpatient surgery in private facilities very attractive provided a standardized protocol is applied. The aim of this study was to assess this kind of innovative collaboration in abdominal surgery from a clinical and economical perspective.
  
  
  METHODS
  All consecutive patients operated on in an outpatient basis in a private facility by a public hospital abdominal surgeon and an assistant over a 5-year period (2004-2009) were included. Clinical assessment was carried out from patients' charts and satisfaction questionnaire, and economic assessment from the comparison between the surgeons' charges paid by the private facility and the surgeons' hospital salaries during the days devoted to surgery at the private facility.
  
  
  RESULTS
  Over the 5 years, 602 operative procedures were carried out during 190 operative days. All patients could be discharged the same day and only 1% of minor complications occurred. The patients' satisfaction was 98%. The balance between the surgeons' charges paid by the private facility and their hospital salary costs was positive by 25.8% for the senior surgeon and 12.6% for the assistant or, on average, 21.9% for both.
  
  
  CONCLUSIONS
  Collaboration between an overloaded university hospital surgery department and a private surgical facility was successful, effective, safe, and cost-effective. It could be extended to other surgical specialities.
authors.affiliation: Department of Visceral Surgery, University Hospital, Lausanne, Switzerland. henri.vuilleumier@chuv.ch
authors.forename: Henri
authors.initials: H
authors.lastname: Vuilleumier
authors.forename: Guy
authors.initials: G
authors.lastname: Coquelin
authors.forename: Jean-Blaise
authors.initials: JB
authors.lastname: Wasserfallen
authors.forename: Nicolas
authors.initials: N
authors.lastname: Demartines
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000191:economics*; D017081:Cholecystectomy, Laparoscopic / Q000191:economics; D003107:Colorectal Surgery / Q000191:economics; D005251:Fees, Medical / Q000706:statistics & numerical data; D005260:Female; D006269:Health Facilities, Proprietary / Q000191:economics* / Q000706:statistics & numerical data*; D059685:Herniorrhaphy / Q000191:economics; D006779:Hospitals, Public / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012456:Salaries and Fringe Benefits / Q000706:statistics & numerical data; D013557:Switzerland; D014850:Waiting Lists; D055815:Young Adult