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  1. Day case surgery trends in England : the influences of target setting and of general practitioner fundholding.

    Article - En anglais

    Objectives 

    To describe the trends in the proportion of elective surgery carried out as day cases, and the impact of the setting of targets and the introduction of general practitioner (GP) fundholding on the use of day surgery.

    Methods 

    Cross-sectional analysis of Hospital Episode Statistics for England, 1990/1991 to 1994/1995, comparing procedures for which targets were and were not set, and comparing types of purchaser (GP fundholder and health authority).

    Results 

    Elective surgical procedures increased from 2.7 million in 1990/1991 to 3.9 million in 1994/1995, a 44% increase.

    Increased numbers of day cases (up 117%) accounted for almost all of the increased total activity.

    The proportion of day cases rose from 35% to 53% over the period.

    Those procedures for which targets were set (over 25% of elective surgery) had a slightly lower day case proportion in 1990/1991 (34% compared to 36%) but slightly higher by 1994/1995 (57% compared to 52%). GP fundholders generally had slightly lower proportions treated as day cases compared to health authorities.

    Conclusions 

    Day cases were additional to, rather than a substitute for, inpatient treatments.

    Setting day case targets may have been associated with growth in use of day surgery, but there was no association with type of purchaser.

    (R.A.).

    Mots-clés Pascal : Ambulatoire, Soin, Chirurgie, Spécialité médicale, Royaume Uni, Europe, Monde, Médecin généraliste, Médecin, Personnel sanitaire, Travailleur social, Recommandation, Angleterre, Grande Bretagne, Europe Ouest, Aspect politique, Géographie

    Mots-clés Pascal anglais : Ambulatory, Care, Surgery, Medical specialty, United Kingdom, Europe, World, General practitioner, Physician, Health staff, Social worker, Recommendation, England, Great Britain, Western Europe, Political aspect, Geography

    Notice produite par :
    ORS Auvergne - Observatoire Régional de la Santé d'Auvergne

    Code Inist : 002B30A11. Création : 19/02/1999.