title: Pediatric hernia repair: 1-stop shopping.
abstract: OBJECTIVE
  Multiple visits for the evaluation, treatment, and follow-up of straightforward surgical problems are inconvenient, can result in lost work for the parents, and missed school for the child. We hypothesized that with proper previsit screening, patients with select diagnoses can be evaluated in an outpatient clinic setting and undergo operation the same day.
  
  
  METHODS
  Criteria were developed to identify straightforward referrals to our surgical practice for umbilical, epigastric, or inguinal hernias. Scripting was created to offer families the option of consultation and, if indicated, surgical treatment on the same day. Data collected included number of patients, cases performed, insurance status, and consultation reimbursement and surgical fees. Families were surveyed postoperatively.
  
  
  RESULTS
  Sixty-one patient candidates participated. The diagnosis and indication for surgery were confirmed in 56 (92%), of which 50 underwent repair the day of their consultation. Seventy-two percent of patients had commercial insurance, whereas 28% had Medicaid. The preoperative consultation fee was reimbursed in 39 (78%) of 50 encounters (57% Medicaid, 86% commercial). All surgical cases were reimbursed. Patient and family satisfaction was high.
  
  
  CONCLUSIONS
  We conclude that it is feasible to provide same-day evaluation and service for straightforward pediatric hernias with acceptable financial reimbursement and high parent satisfaction.
authors.affiliation: Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. Sean.Barnett@cchmc.org
authors.forename: Sean J
authors.initials: SJ
authors.lastname: Barnett
authors.forename: Jason S
authors.initials: JS
authors.lastname: Frischer
authors.forename: John A
authors.initials: JA
authors.lastname: Gaskey
authors.forename: Frederick C
authors.initials: FC
authors.lastname: Ryckman
authors.forename: Daniel
authors.initials: D
authors.lastname: von Allmen
mesh_terms: D000556:Ambulatory Surgical Procedures; D002648:Child; D006552:Hernia, Inguinal / Q000601:surgery*; D006554:Hernia, Umbilical / Q000601:surgery*; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D010865:Pilot Projects