[Is short-stay treatment profitable?].

It is often said that the reimbursement from public insurance is too small to make it profitable for hospitals to perform day surgery and outpatient surgery. It is essential to make it clear whether one is referring to transferring a patient from inpatient stay to an outpatient situation of treatment or a patient who would alternatively not have been treated in hospital. In the first case outpatient treatment will be profitable for the hospital even if there is no specific reimbursement. If suitable patients are not transferred to the outpatient department, this must be because the hospital does not find the reimbursement profitable enough to compensate for problems connected with the organizational change. The second case represents an increase in the hospital's capacity and, strictly speaking, is quite different from a comparison of inpatient stays and outpatient treatment. To illustrate the method used to calculate the costs and benefits to the society from day surgery or outpatient treatment, we present key results from an examination of a short-stay unit at the county hospital of Ostfold, in Fredrikstad. Although this was not a pure day surgical unit (60 per cent of the patients remained until the next day), the results shed light on the economic aspects of pure day surgery as well. The most important effect of this unit was an increase in treatment capacity and a reduction in the time the patients spent waiting for treatment. We show that the unit was certainly profitable if patients were on sick leave for at least one percent of the months spent waiting.