News / Study debunks day case perceptions

Trusts that treat more patients as day cases keep fewer patients in overnight for follow-up treatment, according to a study by CHKS.

The consultancy said it was commonly believed that as more patients with complex needs are treated as day cases – driven by the desire to reduce costs – the conversion rate (number kept in overnight) will increase.

However, CHKS said its analysis, which used indicators based on the British Association of Day Surgery (BADS) directory, showed there is still scope to increase day case surgery rates in English hospitals.

It found there was a positive correlation between higher day case rates and lower conversion rates. One trust had 6% more day cases, yet had less than a quarter of the expected conversion rate (adjusted for casemix). Another trust had a relatively poor day case rate and three times as many conversions as the norm.

‘This work overturns a widely held view that there is a ceiling for day case rates,’ said CHKS managing director Jason Harries. ‘CHKS consultants believe that where trusts are able to maintain high day case rates and low conversion rates it is a result of a concerted focus on providing good-quality care pathways by clinicians and management.’

BADS president elect Mark Skues said: ‘This work provides further evidence that the development of quality assured pathways that plan the delivery of patient care from first referral to home discharge, not only enhances day surgery rates, but also reduces the risk of unanticipated overnight admissions.’