[Cost-effectiveness of a hallux valgus day-surgery program]. / Coste-efectividad del proceso hallux valgus en cirugía mayor ambulatoria.

INTRODUCTION: The development of one-day surgery units has shown to be a better use of health resources without reducing quality. The objective of this study was to evaluate the effectiveness and quality criteria of ambulatory surgery program in the Hallux valgus process. MATERIAL AND METHODS: A retrospective study was conducted on a sample of 753 patients who underwent a Hallux valgus process at our institution between 2002 and 2012 (292 in ambulatory surgery cohort and 461 in hospitalization group). The cost-process was evaluated using the Weighted Care Unitas a measuring unit. Secondary data were collected as regards discharge criteria and patient satisfaction. RESULTS: A significant difference was found between Weighted Care Unit spending on in-patient surgery and out-patient surgery. Both samples were comparable and no differences were found between diagnosis and intervention. The admission rate after ambulatory surgery was 2.39%, and the substitution index increased to 56.04%. The ambulatory surgery program was given a satisfaction rating of 84.6 out of 100. CONCLUSIONS: The results of our study indicate that it is possible to maximize the substitution index of the Hallux valgus process leading to a better use of resources and a high degree of patient satisfaction.

Coste-efectividad del proceso hallux valgus en cirugía mayor ambulatoria / Cost-effectiveness of a hallux valgus day-surgery program

Introducción. El desarrollo de las unidades de cirugía mayor ambulatoria ha puesto de manifiesto una mejor utilización de los recursos sanitarios sin mermar la calidad de los mismos. El objetivo del trabajo es valorar la eficacia del programa de cirugía mayor ambulatoria en el proceso Hallux valgus y sus criterios de calidad. Material y métodos. Se analizan retrospectivamente todos los pacientes intervenidos del proceso Hallux valgus en nuestro centro entre de 2002 y 2012 obteniendo una muestra de 753 pacientes (292 en el grupo de cirugía mayor ambulatoria y 461 en el grupo de hospitalización). Se recogen los datos relativos al paciente y los datos relativos al coste, proceso utilizando como unidad de medida la unidad ponderada asistencial. Secundariamente se recogieron los datos en cuanto a los criterios de alta y satisfacción de los pacientes. Resultados. Se encontró una diferencia muy significativa entre el gasto en la unidad ponderada asistencial de pacientes hospitalizados y los que se intervinieron en cirugía mayor ambulatoria. Ambas muestras eran comparables y no se encontraron diferencias demográficas ni de tipos de intervención. El índice de ingreso poscirugía mayor ambulatoria fue de 2,39% y el de sustitución creció hasta el 56,04%. Se obtuvo un índice de satisfacción de 84,6 puntos sobre 100 en el programa de cirugía ambulatoria. Conclusiones. Los resultados de nuestro estudio indican que es posible incrementar al máximo el índice de sustitución del proceso Hallux valgus consiguiendo una mejor utilización de los recursos y con un alto grado de satisfacción de los pacientes (AU)

Introduction. The development of one-day surgery units has shown to be a better use of health resources without reducing quality. The objective of this study was to evaluate the effectiveness and quality criteria of ambulatory surgery program in the Hallux valgus process. Material and methods. A retrospective study was conducted on a sample of 753 patients who underwent a Hallux valgus process at our institution between 2002 and 2012 (292 in ambulatory surgery cohort and 461 in hospitalization group). The cost-process was evaluated using the Weighted Care Unitas a measuring unit. Secondary data were collected as regards discharge criteria and patient satisfaction. Results. A significant difference was found between Weighted Care Unit spending on in-patient surgery and out-patient surgery. Both samples were comparable and no differences were found between diagnosis and intervention. The admission rate after ambulatory surgery was 2.39%, and the substitution index increased to 56.04%. The ambulatory surgery program was given a satisfaction rating of 84.6 out of 100. Conclusions. The results of our study indicate that it is possible to maximize the substitution index of the Hallux valgus process leading to a better use of resources and a high degree of patient satisfaction (AU)