Admission-discharge policies for hysteroscopic surgery: a randomised comparison of day case with in-patient admission

Objective. To study the effectiveness and acceptability of day case hysteroscopic surgery. Design: Prospective randomised controlled trial. Setting: Aberdeen Royal Infirmary. Subjects: One hundred and ninety four consecutive women who underwent hysteroscopic endometrial ablation. intervention: Seventy three women were allocated to day case surgery and 37 to inpatient admission; 84 women though otherwise fit for day case surgery were scheduled for in-patient admission as they lived more than 20 miles away. All women completed a questionnaire 24 h after their operations. Readmission rates were obtained from case notes. Satisfaction rates 12 months after the operation were recorded by means of a follow-up questionnaire. Results: Post-operative pain was absent or slight in 48 (75%) of the women in the day case group, 27 (84%) of women in the in-patient group, and 55 (82%) in the non-randomised in-patient group. Post-operative analgesia was necessary in 34 (52%) women in the day case group, 24 (75%) women in the in-patient group and 36 (53%) women in the non-randomised in-patient group. Hospital costs were significantly less in the day case group. Satisfaction with stay 92% in the day case group, and 100% in the other two groups. Conclusion: In this setting, day care is a safe acceptable and less expensive alternative to in-patient care for hysteroscopic endometrial ablation. (C) 1998 Elsevier Science Ireland Ltd.