Cost-Analysis of Inguinal Herniorrhaphy under General Anesthesia in Same-Day Surgery
Keywords:
Cost-analysis, Same-day surgery, Herniorrhaphy, Under GAAbstract
Background: Same-day Surgery (SDS) was the protocol that operated and discharged the patient on the same day. The benefits of SDS were decreasing crowdedness, decreasing waiting time, increasing the accessibility of medical services, and decreasing the cost of medical care. Several studies have shown herniorrhaphy under general anesthesia (GA) was safe and could be done in SDS. However, no studies evaluated the cost analysis of herniorrhaphy under GA in SDS specifically.
Objective: To compare the medical costs of herniorrhaphy under GA between SDS and traditional care from the hospital’s perspective.
Methods: This study was a retrospective descriptive study. The medical chart of patients who was performed herniorrhaphy under GA at Songkhla Hospital over 5-year (2018-2022) was reviewed. The patients who had ASA class ≥ III, recurrent hernia, bilateral inguinal hernia, herniorrhaphy with an additional procedure, acute incarcerated hernia, and strangulated hernia were excluded from this study. Demographic data and direct medical costs were compared between the SDS group and the traditional group.
Results: 49 patients were recruited for this study. 25 patients in the traditional group and 24 patients in the SDS group. Two cases (8.3%) in the SDS group failed to discharge on the same day. The overall costs were significantly lower in the SDS group (6,081 Baht ± 712 vs 9,445 ± 3,499 Baht, Mean difference 3,246 Baht, p > 0.001). The length of stay was significantly shorter in the SDS group (0.31 ± 0.19 days vs 3.33 ± 2.13 days, Mean difference 3.11 days, p > 0.001). No significant difference in overall complications between both groups.
Subgroup analysis of patients without complication was shown the same result. The overall cost, total labor costs, and medication costs were still significantly lower in the SDS group. The material costs were significantly higher in the SDS group.
Conclusion: Herniorrhaphy under GA in same-day surgery had lower medical costs, shorter length of stay, and no difference in overall complications compared to traditional care.
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