Introduction

Day case surgery (DCS) forms an increasingly large part of all surgery performed in the developed world. In fact, it was an American anaesthesiologist who opened the first ‘Downtown Anaesthesia Clinic’ in Iowa in the early 1900s. Today about 60% of all surgery in the US is performed in day case units and about 50% of surgery in UK is ambulatory. In this context, the UK Department of Health (2002) has recently published a ‘Basket of 25’ of the most important procedures to be performed as DCS.

Advantages of DCS

• Better patient satisfaction: Patients may choose their admission date, leading to greater satisfaction and a substantial decrease in appointment cancellations. Furthermore, patients subsequently go home; in fact, to much more agreeable and convenient surroundings for their recovery.

• Greater cost effectiveness: Procedures in DCS can be performed in a much more cost- and time-effective fashion, thus increasing the numbers of patients that can be treated, resulting in shorter waiting lists.

Disadvantages of and differences between DCS and inpatient surgery

• Quality standards must be set higher for DCS than inpatient surgery because complications have a greater overall impact and the opportunity and time for correcting problems is much more limited.

• DCS has a narrower range of analgesic drugs/regimens/techniques available because of higher security and quality standards.

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