THE FINANCIAL IMPLICATIONS OF UNPLANNED ADMISSIONS IN 3 COMMON DAY CASE PROCEDURES : A RETROSPECTIVE COST ANALYSIS. kirtana.pswamy@gmail.com

PW03-07

THE FINANCIAL IMPLICATIONS OF UNPLANNED ADMISSIONS IN 3 COMMON DAY CASE PROCEDURES : A RETROSPECTIVE COST ANALYSIS.

4

United Kingdom

Oral or Poster

Day surgery is a cost-effective approach that minimizes hospital stays and enhances patient recovery. However, unplanned admissions after day surgery can increase hospital costs and complicate patient care. The Getting It Right First Time (GIRFT) initiative promotes the optimization of surgical practices by providing guidelines to mitigate factors such as unplanned admissions.

A retrospective audit conducted from January 2022-2023 identified all unplanned admissions for three procedures : Inguinal hernia repairs, laparoscopic cholecystectomies and para umbilical hernia repairs. A cost analysis was performed comparing the median costs of day case discharges (n=6) vs unplanned admissions(n=6)

18/152(12%) of Inguinal hernia repairs were found to be unplanned admissions. The median cost of which was £3,086, compared to £3,339.5 in day case discharges, reflecting a 8.2% decrease in the cost burden.However, Day case discharges exhibited more predictable cost variation while unplanned admissions had a much broader variability. In Laparoscopic Cholecystectomies 51/228(22%) were unplanned admissions. The median cost stood at unplanned admissions was at £7,652, compared to £3,876 for day case discharges, indicating an increase in cost burden by 49.3%. Among paraumbilical hernia repairs 7/55 (14.5%) had unplanned admissions. The median cost being £3,146, compared to £1,610.5 for day case discharges, showing a stark increase of costs by 70.2%.

Unplanned admissions in day surgery result in substantial cost increases, which could be mitigated by adhering to the GIRFT guidelines. Prioritizing day case surgeries where clinically appropriate, improving pre-operative assessments and current discharge pathways may build financial efficiency and contribute towards alignment with GIRFT principles