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Implementation of Day Surgery in Denmark Compared with Benchmarks from the United Kingdom: A Nationwide
Kathrine Hald1, Jakob Nebeling Hedegaard1, John Asger Petersen2
1Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Background:
Day surgery is a safe and cost-effective alternative to inpatient surgery, and the British Association of Day Surgery (BADS) has developed national benchmarks which provide recommended day surgery case rates to guide implementation and monitoring. Although Denmark has seen substantial growth in day surgery over recent decades, the absence of national benchmarks limits systematic assessment and international comparison. Thus, the aim of this study was to map and evaluate the implementation of day surgery in Denmark between 2013 and 2022 and to compare it with recommended day-case rates from BADS.
Methods:
A nationwide, historical register-based open cohort study was conducted, including all Danish citizens aged ≥18 years who underwent one of 16 selected surgical procedures between 2013 and 2022 in public or private hospitals. The primary outcome was the annual distribution of outpatient and inpatient procedures, compared with the BADS 2025 recommended day-surgery case rates. Secondary outcomes were mean inpatient length of stay, 30-day readmission, 30-day reoperation, and 90-day all-cause mortality.
Results:
Of 441,413 procedures, 189,584 (42.9%) were performed as outpatient and 251,829 (57.1%) as inpatient procedures. The proportion of outpatient procedures increased steadily and exceeded the proportion of inpatient procedures by 2022. Comparison with BADS 2025 targets showed substantial variation in the implementation of day surgery across types of procedures. The mean inpatient length of stay declined from 2.8 to 1.9 days. Patient safety indicators showed consistently low risks both among inpatient and outpatient procedures.
Conclusion:
Day surgery increased markedly in Denmark from 2013 to 2022 and now exceeds inpatient volumes for selected procedures. However, major variability across surgical fields remains. The findings support the hypothesis that a continued focus on implementation of day surgery could improve efficiency, free hospital capacity, and align Danish practice with British benchmarks without compromising patient safety.
