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CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1987 Jul 1;137(1):21–26.

Day-care versus inpatient pediatric surgery: a comparison of costs incurred by parents.

R S Stanwick, J M Horne, D M Peabody, R Postuma
PMCID: PMC1492391  PMID: 3594330

Abstract

The cost-effectiveness for parents of day-care pediatric surgery was assessed by comparing time and financial costs associated with two surgical procedures, one (squint repair) performed exclusively as a day-care procedure, the other (adenoidectomy) performed exclusively as an inpatient procedure. All but 1 of 165 eligible families participated. The children underwent surgery between February and July 1981. The day-care surgery group (59 families) incurred average total time costs of 16.1 hours, compared with 37.1 hours for the inpatient surgery group (105 families), as parents in the latter group remained with their child during the longer hospital stay. Parents from out of town incurred the greater time and financial costs. In both groups parents of younger children tended to spend more time at the hospital than parents of older children. Type of surgical management was not a significant factor in out-of-pocket expenses. Loss of income was associated with employment of the mother as a professional or a manager and may reflect inequalities in access to compassionate leave between men and women in equivalent positions. Opening day-care surgery facilities on weekends might reduce the financial burden on working mothers. Overall, day-care surgery was found to be cost-effective for families.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ahlgren E. W. Pediatric outpatient anesthesia. A four-year review. Am J Dis Child. 1973 Jul;126(1):36–40. doi: 10.1001/archpedi.1973.02110190032006. [DOI] [PubMed] [Google Scholar]
  2. Atwell J. D., Burn J. M., Dewar A. K., Freeman N. V. Paediatric day-case surgery. Lancet. 1973 Oct 20;2(7834):895–896. doi: 10.1016/s0140-6736(73)92020-5. [DOI] [PubMed] [Google Scholar]
  3. Bergman A. B., Shrand H., Oppé T. E. A pediatric home care program in London--ten years experience. Pediatrics. 1965 Sep;36(3):314–321. [PubMed] [Google Scholar]
  4. Berk A. A., Chalmers T. C. Cost and efficacy of the substitution of ambulatory for inpatient care. N Engl J Med. 1981 Feb 12;304(7):393–397. doi: 10.1056/NEJM198102123040704. [DOI] [PubMed] [Google Scholar]
  5. Burn J. M. A blueprint for day surgery. Anaesthesia. 1979 Sep;34(8):790–805. doi: 10.1111/j.1365-2044.1979.tb06413.x. [DOI] [PubMed] [Google Scholar]
  6. Cohen D., Keneally J., Black A., Gaffney S., Johnson A. Experience with day stay surgery. J Pediatr Surg. 1980 Feb;15(1):21–25. doi: 10.1016/s0022-3468(80)80396-4. [DOI] [PubMed] [Google Scholar]
  7. Davenport H. T., Shah C. P., Robinson G. C. Day surgery for children. Can Med Assoc J. 1971 Sep 4;105(5):498–501. [PMC free article] [PubMed] [Google Scholar]
  8. Evans R. G., Robinson G. C. Surgical day care: measurements of the economic payoff. Can Med Assoc J. 1980 Nov 8;123(9):873–880. [PMC free article] [PubMed] [Google Scholar]
  9. Ford J. L., Reed W. A. The surgicenter. An innovation in the delivery and cost of medical care. Ariz Med. 1969 Oct;26(10):801–804. [PubMed] [Google Scholar]
  10. Glen P. M., El-Shafie M., Klippel C. Outpatient pediatric surgery: the consumer's view. Ohio State Med J. 1980 Dec;76(12):731–733. [PubMed] [Google Scholar]
  11. LAWRIE R. OPERATING ON CHILDREN AS DAY-CASES. Lancet. 1964 Dec 12;2(7372):1289–1291. doi: 10.1016/s0140-6736(64)92756-4. [DOI] [PubMed] [Google Scholar]
  12. Lawrie R. Why keep them in? Nurs Times. 1971 Jan 21;67(3):79–80. [PubMed] [Google Scholar]
  13. Marcovitch H., Davenport H. T., Grant D. B., Liberman M. M., Valman H. B. District paediatric day care. Arch Dis Child. 1975 Aug;50(8):648–651. doi: 10.1136/adc.50.8.648. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Morse T. S. Pediatric outpatient surgery. J Pediatr Surg. 1972 Jun-Jul;7(3):283–286. doi: 10.1016/0022-3468(72)90125-x. [DOI] [PubMed] [Google Scholar]
  15. Natof H. E. Complications associated with ambulatory surgery. JAMA. 1980 Sep 5;244(10):1116–1118. [PubMed] [Google Scholar]
  16. Othersen B. H., Jr, Clatworthy H. W., Jr Outpatient herniorrhaphy for infants. Am J Dis Child. 1968 Jul;116(1):78–80. doi: 10.1001/archpedi.1968.02100020080011. [DOI] [PubMed] [Google Scholar]
  17. Pineault R., Contandriopoulos A. P., Valois M., Bastian M. L., Lance J. M. Randomized clinical trial of one-day surgery. Patient satisfaction, clinical outcomes, and costs. Med Care. 1985 Feb;23(2):171–182. doi: 10.1097/00005650-198502000-00008. [DOI] [PubMed] [Google Scholar]
  18. Postuma R., Ferguson C. C., Stanwick R. S., Horne J. M. Pediatric day-care surgery: a 30-year hospital experience. J Pediatr Surg. 1987 Apr;22(4):304–307. doi: 10.1016/s0022-3468(87)80229-4. [DOI] [PubMed] [Google Scholar]
  19. Robinson G. C., Shah C. P., Argue C., Kinnis C., Israels S. A study of the need for alternative types of health care for children in hospitals. Pediatrics. 1969 May;43(5):866–878. [PubMed] [Google Scholar]
  20. Ruckley C. V. Day care and short stay surgery for hernia. Br J Surg. 1978 Jan;65(1):1–4. doi: 10.1002/bjs.1800650102. [DOI] [PubMed] [Google Scholar]
  21. Shah C. P., Robinson G. C., Kinnis C., Davenport H. T. Day care surgery for children: a controlled study of medical complications and parental attitudes. Med Care. 1972 Sep-Oct;10(5):437–450. doi: 10.1097/00005650-197209000-00007. [DOI] [PubMed] [Google Scholar]
  22. Steward D. J. Experiences with an outpatient anesthesia service for children. Anesth Analg. 1973 Nov-Dec;52(6):877–880. [PubMed] [Google Scholar]
  23. Steward D. J. Outpatient pediatric anesthesia. Anesthesiology. 1975 Aug;43(2):268–276. doi: 10.1097/00000542-197508000-00012. [DOI] [PubMed] [Google Scholar]
  24. Tisdale B. "Not for admission". Can Nurse. 1972 Dec;68(12):35–39. [PubMed] [Google Scholar]

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