Hospitals have moved some urologic surgeries from inpatient to outpatient setting, which is believed to have increased complications following the surgery and very likely resulted in higher mortality rates.
Usually, in an outpatient surgery setting, a patient does not have to stay in the hospital overnight. The purpose of outpatient surgery procedure is to keep costs low and save time for patients. However, such a procedure means that the patient may not receive relevant care after being operated. Several urologic surgeries are also conducted in an outpatient setup.
A recent research conducted at the Henry Ford Hospital used the Nationwide Inpatient Sample to identify patients, who were discharged following a urologic surgery between 1998 and 2010. They examined the overall as well as "failure to rescue" (FTR) mortality rates of these patients and found that the overall mortality rate remained stable but deaths linked to FTR increased significantly.
The researchers also highlighted that the number of inpatient surgeries has reduced and there is a significant shift to outpatient surgery, which may have spiked the FTR rate.
FTR is a quality measure that emerged after the Institute of Medicine published the "To Err is Human" report in 1999. The report pointed out some important concerns related to the safety of patients in American hospitals. Dr. Jesse D. Sammon, a researcher at Henry Ford's Vattikuti Urology Institute and the lead author of the study explains that FTR is the inability of an institution to identify key problems and take necessary actions before a patient's death.
The researchers also analyzed the age, race, insurance status and any chronic disease suffered at the time of the disease. The study revealed that patients who were older, belonged to a minority community, suffered from other diseases and with public insurance were at higher risk of dying after the detection of complications following a urologic surgery.
Dr. Sammon says that urological surgeons, as well as support staff should be able to understand signs of any complication to avoid a patient's death.
The findings of the study highlight the need of an increased level of attention given towards the care of patients who have undergone urologic surgery to reduce the mortality rate related to complications following the surgery.
The study has been published online by BJUI.
