Medibank: surgeons ignore day case advice on hernia repair

Medibank says surgeons are ignoring guidelines on day procedures for hernia to keep patients in hospital overnight.

A study shows that up to 80 per cent of hernia repair surgeries could be done as day procedures.

Private health insurance giant Medibank has revealed that many surgeons are ignoring guidelines on hernia procedures and overwhelmingly keeping patients unnecessarily in hospital overnight.

New research by Medibank and the Royal Australasian College of Surgeons showed that up to 80 per cent of hernia repair surgeries in private hospitals could be done as day procedures, without the need for an overnight hospital stay. But only 20 per cent of those surgeries in the private system are done as same-day procedures.

Medibank’s chief medical officer, Linda Swan, said the findings could improve the outlook for many hernia patients, who comprise more than 4200 Medibank customers annually. “The report by RACS and Medibank highlights that day hernia repair is appropriate for most patients,” she said.

A Credit Suisse report on Australian hospitals has outlined that the average case payment for an overnight admission, across the health sector, was about eight times that of a day case, highlighting that an increase in day procedures could affect hospital revenues. The report said that day-case admissions now represented about 62 per cent of total private hospital episodes, a figure Credit Suisse expected to increase because of affordability concerns across the private health insurance sector.

Medibank and RACS last year agreed to publish surgical variance reports, which highlight significant gaps in what some surgeons charge, plus lengths of stay and rates of readmission for a range of procedures.

The latest report, on general surgery procedures, showed the high number of patients admitted to hospital overnight for a hernia repair procedure.

A day procedure costs on average $2400, while an overnight stay for the same procedure can cost about $3550.

Medibank, which covered more than 1.3 million hospital admissions in the 2015-16 financial year, said Australian and international guidelines recommended day surgery for most patients undergoing inguinal hernia repair surgery, provided that suitable patient assessment is undertaken and appropriate post-surgery care is available.

RACS surgical director of research and evaluation, Guy Maddern, said that although a change in clinical practice and current culture may take some time and effort, a shift could be made. “RACS will be encouraging surgeons across Australia to take note of the findings and identify ways to increase Australian private hospital day hernia rates from the current 20 per cent to the 70- 80 per cent recommended in the report,” Professor Maddern said.