Tony Lambert delphine1939@videotron.ca
11 Janvier 2007
Day surgery becoming the norm, data show
Demand for operations is climbing, but most are performed on outpatients
ANDRÉ PICARD
From Thursday's Globe and Mail
Staying overnight in hospital after surgery is slowly becoming a thing of the past.
Over the past decade, the amount of day surgery has jumped by more than 30 per cent, while the number of operations requiring a hospital stay has dropped by almost 17 per cent, according to newly released data.
"We're really seeing a shift to day surgery," Caroline Heick, director of health-services information at the Canadian Institute for Health Information, said in an interview. "The numbers support what we know anecdotally."
What is less clear, however, is the financial impact of the shift, if any.
Over all, there were 2.8 million hospital stays in Canada last year, compared with 3.2 million a decade earlier.
The number of hospital stays fell in every province and territory except Alberta and Yukon, both of which have had significant population growth.
The CIHI estimates that about one-third of the decrease in hospital stays is attributable to the trend toward day surgery. But the fact that fewer patients are staying overnight does not necessarily mean hospitals are closing more beds.
"The issue of bed closures is difficult to measure," Ms. Heick said. "You can't say fewer surgeries equal fewer beds; you can't make that jump."
About 8.2 per cent of Canadians had hospital stays last year, according to the report. That is down from 11 per cent in 1996. However, the time people spend in hospital has remained relatively unchanged at an average of 7.2 days.
While the setting for surgery has shifted from inpatient to outpatient, the total number of operations has climbed steadily over the past decade, according to the CIHI.
In fact, demand for surgery is outpacing population growth. This suggests that as the population ages and new technologies are introduced, more procedures are done.
Ms. Heick said new, less invasive procedures such as arthroscopy are driving the increase in elective surgery.
Last year in Canada, there were about 1.76 million outpatient operations, compared with about 442,000 inpatient procedures.
There are about 900 hospitals in the country, and they are the single largest component of health-care spending. They accounted for 29.8 per cent of the $148-billion cost of delivering health-care services last year, or $44-billion.
Pregnancy and childbirth are the most common reasons for hospital stays in Canada.
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Staying the night on the wane
While Canada's hospitals report fewer inpatient stays from a decade ago, surgery in which the patient leaves the same day is on the increase.
Outpatient operations*
1995-'96: 1,348,700
2005-'06: 1,759,800
Short-term hospital stays**
1995-'96: 3,236,600
2005-'06: 2,803,300
*One hospital in New Brunswick did not submit four periods of data for 2004-2005.
Day surgery data not available for Alberta, Saskatchewan, Manitoba and Quebec.
**One hospital in New Brunswick did not submit four periods of data for 2004-2005.
Three hospitals in Alberta did not submit full periods of data for 2005-2006.
SOURCE: CANADIAN INSTITUTE FOR HEALTH INFORMATION
