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  1. Does a shorter length of hospital stay affect the outcome and costs of hysterectomy in southern England ?

    Article - En anglais

    Study objective

    To see whether a shorter postoperative length of stay (LOS) for a major procedure, abdominal hysterectomy for benign conditions, was associated with health outcome, the use of formal and lay care after discharge, cost, and satisfaction.

    Design

    Prospective cohort study.

    Setting

    Three hospitals in London and three in Hertfordshire and Bedfordshire.

    Patients

    A total of 363 women undergoing total abdominal hysterectomy with or without oophorectomy : 112 with a short postoperative LOS (five days or less) and 251 with a standard LOS (six days or more).

    Main outcome measures

    Wound infection within 10 days and six weeks ; change in general health status (Nottingham health profile) after six weeks ; general health and change in social activity (lifestyle index) three months after surgery.

    Mean cost difference for hospitals, use of formal and lay care after discharge, and patient satisfaction.

    Results

    Short LOS was associated with benefits : a lower risk of wound infection in the first 10 days (odds ratio 0.44 ; p=0.03) and no deterioration in physical mobility (measured using the NHP) after six weeks - and with adverse outcomes : constipation six weeks later (OR 0.48 ; p<0.001) and moderate or severe urinary symptoms six weeks (OR 0.69 ; p<0.004) and three months (OR 0.65 ; p<0.008) later.

    On multivariate analysis, the only outcome to remain significantly associated with LOS was physical mobility after six weeks (p=0.024). (...)

    Mots-clés Pascal : Hystérectomie, Temps séjour, Hôpital, Postopératoire, Pronostic, Coût, Satisfaction, Homme, Femelle, Economie santé, Angleterre, Grande Bretagne, Royaume Uni, Europe, Chirurgie, Abdomen pathologie, Appareil digestif pathologie

    Mots-clés Pascal anglais : Hysterectomy, Residence time, Hospital, Postoperative, Prognosis, Costs, Satisfaction, Human, Female, Health economy, England, Great Britain, United Kingdom, Europe, Surgery, Abdominal disease, Digestive diseases

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0009478

    Code Inist : 002B25G04. Création : 21/05/1997.