Patients' Recognition on the Laparoscopic Cholecystectomy -Propriety of Switching to the Day-care Surgery-

Yasuki Unemura, Shuichi Fujioka, Takashi Imai, Katsumaro Suzuki, Takeyuki Misawa, Ryuzo Murai, Kazuhiko Yoshida, Susumu Kodbayashi and Yoji Yamazaki

The Jikei University School of Medicine Department of Surgery

We investigated the patients' opinion on laparoscopic cholecystectomy, which has the reputation of becoming one of the day-care surgical procedures of the future. The most desirable admission day in the day before the operation: 55%, 2-3 days prior to the operation: 43% and on the day of the operation: 2%. The request admission on the day of the operation was considered to be due to personal reasons. More than 83% of the patients did not mind the increase in the charge caused by a prolonged postoperative period. Eighty percent of patients had taken out some form of private sickness insurance and 86% of them applied to their insurance company for payment. The incremental daily charge that may well make patients want to shorten the hospital stay is 10,000 yen as a standard. The average postoperative period is 4.5± 1.9 days for all patients, and those classified by the patients' degree of work-load were: extremely busy: 3.7± 0.8; busy: 4.3±1.9; relatively no work pressure; 4.5±1.9; and no pressure of work: 5.2± 2.0 days respectively. The group without any work pressure had a statistically significant prolonged postoperative period compared with the extremely busy and busy groups. However, 87% of all patients were of the opinion that the same postoperative period as they experienced was suitable, and 8% of the patients desired a shorter stay. In addition, patients who positively desired a decrease in the postoperative stay without any change of the charge were about 3% of all patients. In conclusion, patients of this study still have not recognized laparoscopic cholecystectomy as a day-care surgical procedure in the present health care system.

Key words
day-care surgery, ambulatory surgery, laparoscopic cholecystectomy, DRG/PPS

Reprint requests
Yasuki Unemura Department of Surgery, The Jikei University School of Medicine 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461 JAPAN

Accepted
July 28, 1999

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