Persistent Low Uptake and Inconsistent Adoption of Same Day Hernia Repair for Privately Insured Patients in Australian Hospitals
Celine Northcott, Padam Dahal, Alun Cameron, Guy J. MaddernABSTRACT
Background
Hernia repair can safely be provided as a same‐day procedure. However, despite advice from published guidelines, previous analyses of Australian data have shown low rates of same‐day surgery in private hospitals for hernia repairs.
Methods
This study used aggregated administrative data for Medibank‐insured patients treated in Australian hospitals between 1 January 2015 and 31 December 2024 for surgical repairs of inguinal, femoral, or umbilical hernias to analyse trends in same‐day services.
Results
The proportion of hernia procedures performed as same‐day separations increased over time, rising from 22.7% in 2015 to 31.0% in 2024 ( p < 0.001). The average length of stay (LOS) among patients requiring overnight admission remained stable (1.26 days in 2015; 1.23 days in 2024). Same‐day separations were most common for umbilical repairs (47.5%), compared with femoral (23.7%) and inguinal repairs (22.0%). Female patients had a higher proportion of same‐day separations (29.5%) compared with male patients (25.8%, p < 0.001), but a higher average LOS (1.31 days, p < 0.001). The use of same‐day surgery varied across hospital locations.
Conclusions
Despite a groundswell of evidence, changes in surgical practice to adopt same‐day hernia repair for privately‐insured patients are happening very slowly and are well below the recommended target of 70%–80%. The rise in same‐day separations appears to reflect greater use of day‐case pathways rather than shorter hospital stays among patients requiring admission overnight. Variation across locations suggests opportunities to improve consistency in care delivery through system‐level changes, and for same‐day hernia repair to become routine practice across all hospitals in Australia.