title: [Assessment of the impact of day care surgery promotion on attending physician consultation rate: a prospective study].
abstract: BACKGROUND
  In order to control health spending, health authorities encourage medical staffs to develop day care surgery. Gynecologic day care surgery can easily be developed. However, consequences of the reduction of hospital stay on the rate of postoperative consultation with the attending physician have not been evaluated. Will day care surgery lead to an increase in postoperative consultation with attending physician rate?
  
  
  OBJECTIVE
  Assessment of the impact of day care gynecological surgery on attending physician postoperative consultation rate.
  
  
  METHODS
  This prospective study included 250 women who have gynecologic surgery in the gynecologic unit of a teaching hospital, from April to June 2012. Postoperative consultations with attending physician were identified with a phone questionnaire. Postoperative consultation rate with attending physician was compared between women supported in day care surgery versus conventional surgery.
  
  
  RESULTS
  Two hundred and fifty women were included in the study, 166 (66.5%) had a day care surgery while 84 (33.5%) had a traditional hospitalisation for surgery. Mean age of women was significantly lower in the group of day care surgery (42.08 years [40.14-44.03] versus 54.15 years [50.45-57.86], P<0.01). Out of the 166 women with a day care surgery, 49 (30%) went to the attending physician while 25 out of 84 (30%) in the traditional hospitalization group. Postoperative consultation rate with attending physician was not significantly different between women supported in day care surgery compared to those supported in conventional surgery (P>0.05).
  
  
  CONCLUSIONS
  This study did not find any difference in the postoperative consultation rate with the attending physician after a day care surgery versus surgery in conventional hospitalization in gynecology. This result should be interpreted cautiously as women are different between the two groups (different surgeries, older women with more associated pathologies in the conventional hospitalization group). Vigilance must be maintained on this risk of increasing postoperative consultation rate with attending physician after day care surgery.
authors.affiliation: Service de gynécologie-obstétrique, hôpital Bicêtre, GHU Sud, AP-HP, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre, France; Inserm, Centre de recherche en épidémiologie et santé publique (CESP), U1018, 94276 Le Kremlin-Bicêtre, France; Faculté de médecine, université Paris-Sud, 94276 Le Kremlin-Bicêtre, France. Electronic address: perrine.capmas@bct.aphp.fr.
authors.forename: P
authors.initials: P
authors.lastname: Capmas
authors.affiliation: Service de gynécologie-obstétrique, hôpital Bicêtre, GHU Sud, AP-HP, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre, France.
authors.forename: B
authors.initials: B
authors.lastname: Duparc
authors.affiliation: Service de gynécologie-obstétrique, hôpital Bicêtre, GHU Sud, AP-HP, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre, France; Inserm, Centre de recherche en épidémiologie et santé publique (CESP), U1018, 94276 Le Kremlin-Bicêtre, France; Faculté de médecine, université Paris-Sud, 94276 Le Kremlin-Bicêtre, France.
authors.forename: H
authors.initials: H
authors.lastname: Fernandez
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D008875:Middle Aged; D011182:Postoperative Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*
keywords: Ambulatoire; Ambulatory; Attending physician; Chirurgie ambulatoire; Chirurgie gynécologique; Day care surgery; Gynecologic surgery; Médecine de ville; Médecine générale