Day surgery for hip/knees/HV etc, how and why?
PGY2 in Asia here.
I keep hearing that in the US and Europe, a lot of clinics do TKA/THA/Hallux valgus operations on a day surgery basis (admit and discharge the same day as surgery).
The explanation I am given is usually "It's so expensive to hospitalize someone there even for one day, so they can't afford to stay longer."
Some might say "Americans have always been a very independent people so they are good at taking care of themselves."
However, looking at our own cases, TKA and THA patients are usually still bedridden on OP day, and about half need a fair bit of encouragement to even get out of bed on POD1. I have a hard time picturing these folks being discharged and hopping on home. Even for very simple surgeries we might have the patient stay one night just to make sure the wound isn't going rip (or whatever crazy story that traumatized the attending when they were young).
Moreover, given the vast distances of the US and relatively difficult access to healthcare, wouldn't there be more incentive to keep the patients inhospital until they are really stable?
Does your institution do day surgeries for TKA/THA/HV, or anything else? If so, is the decision cost-driven, or do you see any other benefits? Do you think the patients would prefer to stay longer in the hospital if they could?