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Major otology day case surgery: viable, cost efficient and safe
J P O'Neill1, O Young, B Conlon
1Department of Otolaryngology, Head and Neck Surgery, St James Hospital, James St, Dublin, Ireland. joneill@rcsi.iel
Insights
Major ear surgery as a day case procedure is safe and effective in adults, achieving high discharge rates and significantly reducing surgical waiting times. This approach offers a cost-efficient alternative to inpatient care.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Health Services Research
Background:
- No prior initiatives in Ireland for major ear surgery as day cases.
- Current healthcare focus on increasing elective day case surgeries.
- Public and political pressure to reduce surgical waiting lists.
Purpose of the Study:
- To evaluate the feasibility and outcomes of major otological surgery as a day case procedure in adults.
- To assess morbidity and readmission rates associated with day case ear surgery.
- To determine the impact on surgical waiting times.
Main Methods:
- Prospective study of 43 adult patients undergoing major otological surgery.
- Data collection over an 18-month period in a tertiary referral center.
- Analysis of morbidity, readmission rates, and procedure-complication relationships.
Main Results:
- Achieved an 88.4% same-day discharge rate.
- Reported a low 2.3% next-day readmission rate.
- No major morbidities observed; no association found between procedure type, age, and complications.
Conclusions:
- Major day case otology surgery is a safe and viable alternative to inpatient procedures.
- Demonstrated favorable discharge rates compared to UK data.
- Day surgery is cost-efficient, expands surgical capacity, and reduces waiting lists.
Background:
There has been no study or institution in Ireland promoting major ear surgery performed as a day case procedure in adults. At present, there is a strong political and financial drive for increased elective day case surgery and also a public responsibility to reduce surgical waiting times.
Methods:
A prospective study of 43-day case otology patients who underwent major otological surgeries over an 18-month period in a tertiary referral center. We recorded morbidity, readmission rates and assessed the relationships between procedures performed and complications observed.
Results:
We report a same day discharge rate of 88.4% with a next day readmission rate of 2.3%. We report no major morbidities and found no association between the otological procedure performed and complications observed. Furthermore, there was no statistical association between age and complications observed. We have reduced our waiting list from 9 months to 4 weeks over the 18-month period.
Conclusion:
Major day case otology surgery is an acceptable alternative to an inpatient procedure with favorable discharge rates in comparison to the UK results. Day surgery in this context is safe, cost efficient and expands the surgical possibilities within our department and specialty.
