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Single visit surgery for pediatric ambulatory surgical procedures: a satisfaction and cost analysis
Jacob K Olson1, Lisa A Deming1, Denis R King1
1Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH.
Insights
Single visit surgery (SVS) significantly reduces family costs and hospital visits. This approach maintains high patient satisfaction and offers a more convenient option for ambulatory surgical procedures.
Area of Science:
- Surgical Innovation
- Health Services Research
- Cost-Effectiveness Analysis
Background:
- Single Visit Surgery (SVS) streamlines ambulatory procedures by combining pre-operative assessment and operation on the same day, with telephone follow-up.
- This model aims to reduce family burden by consolidating hospital visits from 2-3 to a single trip.
- SVS was initiated in 2013 for ambulatory patients with clear surgical indications.
Purpose of the Study:
- To evaluate family satisfaction with Single Visit Surgery (SVS) compared to conventional surgery (CS).
- To quantify the cost savings for families utilizing the SVS model.
- To assess the institutional financial feasibility of implementing SVS.
Main Methods:
- A comparative study matching SVS patients with age and case-matched conventional surgery (CS) patients.
- Family satisfaction was measured through post-operative telephone surveys.
- Family costs were calculated by summing lost revenue (based on median income) and transportation expenses ($0.50/mile).
Main Results:
- High satisfaction rates were observed in both SVS (98%) and CS (93%) groups, with no statistically significant difference (p=0.27).
- A significant preference for SVS was reported by 40% of CS families, while no SVS families preferred the CS option (p<0.001).
- SVS families achieved an estimated cost saving of $188; reimbursement and charges were comparable between the two models.
Conclusions:
- Single Visit Surgery (SVS) offers substantial cost savings for families without compromising patient satisfaction or institutional reimbursement.
- SVS is an effective, less disruptive approach for low-risk ambulatory procedures, improving access to pediatric surgical care.
- The SVS model demonstrates reduced resource utilization and enhanced convenience for families undergoing ambulatory surgery.
Background:
Single visit surgery (SVS) consists of same-day pre-operative assessment and operation with telephone post-operative follow-up. This reduces family time commitment to 1 hospital trip rather than 2-3. We began SVS for ambulatory patients with clear surgical indications in 2013. We sought to determine family satisfaction, cost savings to families, and institutional financial feasibility of SVS.
Methods:
SVS patients were compared to age/case matched conventional surgery (CS) patients. Satisfaction was assessed by post-operative telephone survey. Family costs were calculated as the sum of lost revenue (based on median income) and transportation costs ($0.50/mile).
Results:
Satisfaction was high in both groups (98% for SVS vs. 93% for CS; p=0.27). 40% of CS families indicated that they would have preferred SVS, whereas no SVS families indicated preference for the CS option (p<0.001). Distance from the hospital did not correlate with satisfaction. Estimated cost savings for an SVS family was $188. Reimbursement, hospital and physician charges, and day-of-surgery cancellation rates were similar.
Conclusions:
SVS provides substantial cost savings to families while maintaining patient satisfaction and equivalent institutional reimbursement. SVS is an effective approach to low-risk ambulatory surgical procedures that is less disruptive to families, facilitates access to pediatric surgical care, and reduces resource utilization.
Type Of Study:
Cost Effectiveness Study.
Level Of Evidence:
Level II.
