Organization and efficiency assessment of day surgery units

Background: A key priority in the development of Russia’s healthcare system is primary medical and social care modernization, transitioning to resource-efficient technologies and care models without compromising service quality. Since the 20th century, ambulatory surgical care has been progressing. However, existing efficiency indicators, including economic metrics, do not provide an adequate basis for comparison with 24-hour inpatient facilities.

Materials and methods: This study analyzed the treatment of 35,000 patients at the Department of Ambulatory and Polyclinic Care of the S.M. Kirov Military Medical Academy (2005–2024), alongside statistical data from the annual 2023 Health Care in Russia report, materials from six congresses of ambulatory surgeons, and scientific publications. The organizational structure, specialization, and statistical performance indicators of day surgery units throughout the 21st century were examined.

Results: The number of beds in hospital-based day surgery units between 2010 and 2019 increased by 14.4%, whereas those in outpatient clinics increased by 17.1%. However, the average bed occupancy rate in hospital-based day surgery units decreased from 293 to 287 days and from 322 to 309 days in outpatient-based day hospitals. The average occupancy of 24-hour inpatient hospital beds was 310–319 days. These data indicate the inefficient utilization of day hospital beds due to their underuse, resulting in low economic efficiency.

Conclusions: The inability to accurately assess the efficiency of day surgery units is a crucial issue. Establishing standardized performance indicators, defining the status of day hospital beds, and increasing their turnover rate are required to address this challenge. Direct funding for all day hospitals should be implemented, and the cost of completed treatment cases should be assessed based on a unified base tariff, regardless of the type of medical institution providing care.