Economic considerations and size determination of a surgical day-care unit

The necessity and economic feasibility of a surgical day-care (SDC) unit have been examined. The analysis focuses on plastic surgery (PS) patients, and calculations were crudely extrapolated for all surgical patients. Both the size (i.e. number of beds) of such a unit and its operating costs have been compared with current costs for comparable inpatients. Patients are selected for day care on the basis of four criteria: age, length of stay, diagnosis and distance from hospital. Fifty-nine percent of PS patients are candidates for SDC because of their short stay in hospital. If another criterion is added, 32% of patients meet two criteria. All four criteria are met by 20% of PS patients. About 30% of those satisfying all four criteria are currently treated in the outpatient PS clinic. PS patients constituted 9% of all surgical patients in hospital in 1983. A rough estimate shows that 2255 patients are potential candidates for SDC annually (203 of these are PS patients). Nine beds, three nurses and a secretary are required in an SDC unit. Attending physicians will come from the mother wards. The cost per patient in the SDC ward is 38% lower than that in a surgical ward. The cost per patient is affected mainly by the number of patients treated in the SDC; the effect of other components is negligible.