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Ask the Expert : How to Avoid Hospital Admissions

Dr. Alfred Murage

Dr Alfred Murage is one of Nairobi’s Leading Obstetrician Gynecologists.

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In the past, hospital admissions for reproductive health problems were extremely frequent. However, in the last few decades, women’s health care has changed so much that reasons for admitting women in hospitals are becoming less and less.

Many problems can now be addressed in an outpatient setting, so called ambulatory or day care. Ambulatory care is consultation, treatment, or intervention using advanced medical technology delivered on an outpatient basis. The patient’s stay at the health facility, from registration to discharge, occurs on a single calendar day instead of the past common hospital admissions.

Many gynecological investigations and treatments, for both emergencies and chronic conditions, can be performed on an ambulatory basis. This includes surgical procedures with lower risks of complications.

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Money is the main reason more women are choosing ambulatory healthcare. It is estimated that surgery performed in a day care setting costs 30-60% less than the identical surgery performed in an in-patient hospital setting.

Convenience is another factor. Many women find it more convenient and less stressful to recover at home rather than in a hospital. Advances in anesthesia, microsurgery, and physician skills have made it safe for many procedures that once required a hospital stay.

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In choosing an ambulatory care facility, women should enquire about licensing or certification from appropriate agencies.

The center’s physicians should be competent and certified in the area in which they practice. Other questions that might be asked when selecting high-quality ambulatory care include: Is the center associated with a hospital? Does the center have a hospital admission plan in case of emergencies? How is anesthesia administered and monitored? Will the insurance company reimburse for services provided? How much experience does the center have with the particular procedure or test the client needs?

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Minimally invasive gynecological surgery is especially suited for ambulatory care.

This may include procedures such as treatment for fibroids, endometriosis, ectopic pregnancies, miscarriages, tubal surgery and other minor pelvic surgery. Women must be carefully screened for any proposed day care procedures.

A prior thorough assessment by both the gynecologist and an anaesthetist is mandatory to ensure both suitability and safety. Some women will not be suitable for day care depending on their risk factors and proposed procedures.

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As ambulatory care advances, hospital admissions will slowly dissipate. The equation will change – the most profitable hospitals will be the ones with the most empty beds! That will result in more efficient use of resources, equipment, and technology. Women will have most gains, with limited hospital stays and health care savings.

If you have a condition that seems to require hospital admission, please inquire if ambulatory care is for you. If you must be admitted, your hospital stay should be for the shortest time possible. Many times women can be discharged from hospitals sooner than is currently practiced.

black pregnant woman with a doctor

Summary:
• Ambulatory care (Out-Patient) is suitable for many serious conditions
• Hospital admissions can often be avoided

Read more from Dr Murage on his Blog.

Related: Hospital Packing Checklist

 

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