Paediatric day care surgery: a hidden burden for primary care?
1Department of Paediatric Surgery, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.
Insights
Pediatric day care surgery recovery is typically swift, with most children resuming normal activities within days. However, a significant number of postoperative issues arise, often managed by primary care providers.
Area of Science:
- Pediatric Surgery
- Healthcare Services Research
- Patient Recovery Studies
Background:
- Paediatric day care surgery is increasingly common.
- Understanding postoperative recovery and potential complications is crucial.
- The impact on primary care services requires assessment.
Purpose of the Study:
- To identify 'concealed' postoperative problems in children undergoing day care surgery.
- To evaluate the burden of paediatric day care surgery on primary care.
- To define the normal recovery period for common paediatric procedures.
Main Methods:
- Prospective study involving 651 children (median age 4 years).
- Direct questioning of patients and parents about postoperative issues and recovery time.
- Data collection on unscheduled healthcare contacts and time to normal activity/school return.
Main Results:
- 15.5% of patients had unscheduled postoperative contacts, predominantly with general practitioners (81 cases).
- Most identified problems were minor; major issues were usually detected before discharge.
- High incidence of wound problems noted after circumcision.
- Median recovery time to 'back to normal' was 2 days; return to school was a median of 6 days.
- High rate of primary care contact occurred despite provided advice and open access.
Conclusions:
- Paediatric day care surgery recovery is generally rapid with high patient satisfaction.
- There is a notable burden on primary care services, necessitating effective communication and support.
- Proactive identification of potential issues and clear post-discharge instructions are important for managing paediatric day care surgery outcomes.
Abstract:
The aims of this study were to identify prospectively 'concealed' postoperative problems, to assess the burden of paediatric day care surgery on primary care services and to define a normal recovery period for common children's procedures. At their first postoperative clinic visit, patients and parents were asked directly about postoperative problems, unscheduled contacts with the hospital or other health professionals, and the time taken to resume normal activity and return to school. A total of 651 children, median age 4 years (range 0-16 years) were included. Median time to the first clinic appointment was 42 days (range 4-235 days). There were 100 unscheduled postoperative contacts (15.5% of all episodes) of which 81 were with general practitioners. Most problems recorded were relatively minor, and most requiring major intervention were identified before the child left hospital. There was a very high incidence of wound related problems after circumcision. Most children were 'back to normal' within a few days (median 2 days, range 0-30 days) and back to school within a week (median 6 days, range 1-20 days). There was a high rate of primary care contact despite clear written and verbal advice given in hospital and the offer of open access for any concerns. Recovery from day care surgery was rapid and overall level of patient satisfaction was high.
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