title: Anaesthetic preference and outcomes for elective inguinal hernia repair: a comparative analysis of public and private hospitals.
abstract: OBJECTIVE
  There is paucity of data regarding patient selection criteria, anaesthetic preferences and outcomes of elective inguinal hernia repair in public and private sector in the UK. This study aimed to compare such outcomes.
  
  
  METHODS
  Five hundred and fifty-five consecutive inguinal hernia repairs performed by one consultant surgeon in public and private sector were reviewed from a prospectively maintained database. The patient demographics, anaesthetic choice, day case rates and early and long-term morbidity were analysed.
  
  
  RESULTS
  The median age of the study group was 59 years (range 16-96 years) with a male/female ratio of 21:1. A total of 436 (78 %) patients underwent surgery in the public sector and 119 (22 %) patients in the private sector. The patients undergoing surgery in the private sector were younger compared to public sector (55 vs. 60 years, p = 0.03). The number of patients with ASA grades III and IV was higher in public sector (28.6 %) compared to private sector (p = 0.0001). General anaesthesia was the preferred anaesthetic technique in the private sector (52 %) and local anaesthesia in the public sector (66 %) (p = 0.0002). The day case rates were higher than in the private sector compared to public sector (78 vs. 66.5 %, p = 0.01). No significant difference was noted in the incidence of post-operative complications, recurrence, groin pain and satisfaction rate between the two groups.
  
  
  CONCLUSIONS
  Patients undergoing surgery in the private sector are younger, healthier, prefer general anaesthesia and have higher day case rates compared to public sector. The short- and long-term outcomes are similar between public and private sectors.
authors.affiliation: Ninewells Hospital and Medical School, Dundee, Scotland, UK, sanjay.pandanaboyana@nhs.net.
authors.forename: P
authors.initials: P
authors.lastname: Sanjay
authors.forename: A
authors.initials: A
authors.lastname: Marioud
authors.forename: A
authors.initials: A
authors.lastname: Woodward
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D000768:Anesthesia, General / Q000706:statistics & numerical data*; D000772:Anesthesia, Local / Q000706:statistics & numerical data*; D017558:Elective Surgical Procedures / Q000295:instrumentation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods; D016304:Hospitals, Private / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult