Does surgery have to be expensive? - abstract

ABSTRACT

Because of increasing cost in health care, it was thought valuable to examine critically our current pratice of surgery with specific reference to measures that could result in cost reduction, while maintaining quality surgical care. Our study at Port-of-Spain General Hospital revealed that routine admission of minor head injuries results in necessary hospitalization and X-rays in over 1,000 patients per year. Review of routine chest X-ray and ECG in 1063 consecutive pre-operative cases showed that 95 percent of these indicated. Group and cross-matching of blood, though performed, was found to be unnecessary in 430 major, consecutive cases. In 2946 consecutive minor operations, an haemoglobin assay was found to be indicated in only 8 cases though it was done in all. Nasogastric tubes, urinary catheters and drains were found unnecessary in over 500 cases in one year. Vigilance in other areas such as use of I.V. fluids, I.V. drugs, antibiotics and wound dressings could significantly reduce health care cost. Attention must be paid to cost attainment if we are to continue to provide good care at affordable cost (AU)