Why Have Hospital Stays After Surgery Become so Short?

Hospital stays after surgery, or for things like births or illness, tend to be much shorter than they were in the past. A person with pneumonia in the 1950s might have stayed in the hospital for several weeks to a month, and person who had heart surgery could have been in the hospital for an equally long time. Now it’s not uncommon to see people undergo extensive surgery, such as a bypass operation or a hysterectomy, and leave the hospital within a few days.
There are several reasons why hospital stays after surgery have shortened. First, in general, it can be stated that various surgeries are far improved. Some surgeries of the past, like a hernia operation, required extensive cutting. Today, hernia repair may be done laparoscopically, avoiding huge surgical wounds. Even surgeries that involve open-heart procedures are significantly improved than in previous decades, resulting in many patients being able to go home within a few days. Anesthesiology and drugs used to create sedation are also improved, and many surgeries are now done under partial instead of full sedation, which dramatically speeds recovery time.
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Certainly, costs associated with staying in a hospital are in part responsible for shorter hospital stays after surgery. Staying in a hospital for an extra day or two can mean astronomical increases in price to insurance companies. In fact, some insurance companies do expect or will only cover a stay of a certain time after a given surgical procedure, provided the patient is not having complications. Doctors can usually ignore such recommendations if they feel a patient is not recovered enough to go home.
Many studies also show that patients tend to recover better at home than they do in the hospital. They tend to get ambulatory (walking or moving) more quickly, and they also enjoy a much more restful environment. Hospitals, as any former hospital patient can attest, are not restful places. Strange noises occur throughout the night and day, you’re interrupted in the middle of the night to have your vitals taken, and you may share a room with an inconsiderate patient or with a patient who has visitors coming and going throughout the night. Most home environments tend to promote greater rest, and they also reduce chances of complications due to infections.
Unfortunately, patients who have hospital stays after surgery, particularly if they’re lengthy, may be at increased risk for developing other infections, due to the presence in many hospitals of antibiotic resistant strains of staph bacteria. Hospital workers make every effort to reduce this risk, yet it is still much more common to develop wound infections or pneumonia from bacteria like MRSA in a hospital, than it is to develop it outside of a hospital. Most doctors discourage patients from staying longer than they need because of this risk.
There are numerous studies that support shorter hospital stays after surgery for most people, and that suggest that many procedures performed in surgery outpatient clinics are just as safe as those performed in a hospital. Shorter hospital stays do place more burden of care on friends or family, which may mean that more people must miss work (both the recovering patient and the caretaker). Another issue of shorter hospital stays after surgery arises for patients who may not have access to help or aid at home.
It can be more than burdensome for a person who doesn’t have help to go home when they still feel awful, and may not be able to perform basic self-care. This may not be taken into account when a patient is being discharged, though many times a doctor will recommend a longer stay for someone who does not have friend or family support at home. Another alternative is to provide nursing care at home after a hospital stay, though this may not be covered by all insurance companies.

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