Abstract
BackgroundWorldwide, there has been a marked increase in the number of inguinal and femoral hernia repairs performed as day surgery procedures. This study aimed to outline the epidemiology of the procedures for repairing unilateral inguinal and femoral hernia in the Veneto Region, and to analyze the time trends and organizational appropriateness of these procedures.MethodsDrawing from the anonymous computerized database of hospital discharge records for the Veneto Region, we identified all unilateral groin hernia repair procedures completed in Veneto residents between 2000 and 2009 at both public and accredited private hospitals.ResultsA total 141,329 hernias were repaired in the Veneto Region during the decade considered, with an annual rate of 291.2 per 100,000 population for inguinal hernia (IH) repairs and 11.2 per 100,000 population for femoral hernia (FH) repairs. Day surgery was used more for inguinal than for femoral hernia repairs, accounting for 76% and 43% (p< 0.05), respectively, of all hernia repair procedures completed during the period. The % of other than surgery hospital ordinary admissions (day surgery or ambulatory surgery) during the decade considered rose from 61.7% to 86.7% for IH and from 33.0% to 61.8% for FH.ConclusionsIn the last decade, the Veneto Region has reduced the rate of ordinary hospital admissions for groin hernia repair with a view to improving the efficiency of the hospital network.
Highlights
Worldwide, there has been a marked increase in the number of inguinal and femoral hernia repairs performed as day surgery procedures
The aim of this study was to describe the epidemiology of unilateral inguinal hernia (IH) and femoral hernia (FH) repair in the Veneto Region (North-Eastern Italy) and to analyze how the health care services for these surgical procedures have changed over time
These provisions allow for outpatient hernia repair in patients meeting the requirements of the DRG 162 “Inguinal and Femoral Hernia, age >17, no complications”, and specific codes referring to the specialist branch of “general surgery” were included in the NHS Regional price list for ambulatory services
Summary
There has been a marked increase in the number of inguinal and femoral hernia repairs performed as day surgery procedures. With advances in diagnostic and therapeutic technologies, and surgical and anesthetic techniques, there has been a reduction in the number and duration of conventional hospitalizations and an increasing use of day surgery and ambulatory surgery procedures This is due to the application of organizational models that pursue the efficient management of resources among their main objectives. Day surgery and outpatient or ambulatory solutions can preserve or even increase the level of service quality in terms of outcomes, while reducing any negative consequences relating to prolonged hospital stays. They can lead to shorter waiting lists, and help to rationalize the costs of surgical treatments. In the case of inguinal and femoral hernia repair, the European Hernia Society has published a grade B (“weakly positive”) recommendation that all patients be considered potentially eligible for day surgery [3]
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