Day surgery at Korle Bu Teaching Hospital: a six year review

Day surgery is not simply a matter of economics for the health institution or the individual patient, or improved utilization of scarce and dwindling resources, or even a matter of increasing access to health care, fundamental as this is to us in the developing world. The ultimate question is to what extent does it satisfy the true needs of the patient and meet the requirements of his care as a whole. To address this day surgery in a general surgical unit has been reviewed over a 6 year period. This covered a total of 1547 cases consisting of hernias, hydroceles, excision biopsies, varicose veins etc. Infiltrative local anaesthesia using lignocaine (4 mg/kg) mostly with 1 in 200,000 adrenaline added proved effective in 98 percent of cases; there were no deaths. For the institutions day surgery has proven cost effective, lowering cost of operative treatment and improving utilization of scarce resources. It has also proven eminently acceptable to patients and their families, enhancing access to care and significantly reducing the personal cost of treatment. To demonstrate enhanced health economics future studies should ideally show a parallel diminution of in-patient bed facilities with increasing load of day surgery.