Early discharge after gynaecological surgery.

OBJECTIVE

To determine the safety and acceptability of early discharge after major gynaecological surgery.

DESIGN

Retrospective study of patients discharged home on the third day after surgery. Questionnaire to determine patients' attitudes.

SETTING

District general hospital with an associated 'Hospital at Home Scheme'.

SUBJECTS

102 women listed for major gynaecological surgery living within the catchment area of the Hospital at Home and considered good surgical risks.

MAIN OUTCOME MEASURES

Safety, re-admission rates, nursing time planned and utilised, patients' attitudes.

RESULTS

There were no serious complications. Only three patients required re-admission. Less nursing time was required than expected: allocated, 24 h; utilised, less than 10 h for 45%; no night cover for 70.5%. Patient aides performed most of the nursing. There was no excess burden for general practice (45.7% required a home visit). The scheme proved popular with patients. Analgesia and catheter care needed to be improved.

CONCLUSION

Discharge on the third postoperative day into an augmented domiciliary care service is safe, popular and cost effective.