Objective To analyze the factors influencing day surgery developing towards same-day surgery, and provide a reference for the promotion of same-day surgery. Methods A questionnaire on influencing factors of same-day surgery was prepared based on structural equation modeling (SEM), including 6 dimensions and 23 items. From January to October 2021, at the Day Surgery Center of West China Hospital, Sichuan University, the random sampling method was used to select the research subjects for a questionnaire survey, and SEM was used to analyze the factors impacting the iterative development of day surgery to same-day surgery service model. Results A total of 200 questionnaires were distributed, and 192 valid questionnaires were recovered, with an effective recovery rate of 96.0%. The Cronbach’s α coefficient of the questionnaire was 0.857, and the Cronbach’s α coefficient of each dimension was from 0.832 to 0.934. The KMO test value was 0.822, and the result of Bartlett sphericity test was χ2=4568.330, P<0.001. The model fit indexes met the standard requirements well. The result of SEM revealed that the standard path coefficients of “the hospital’s preliminary preparation for day surgery developing towards same-day surgery” impacting “the guarantee system related to surgical quality and safety”, “the guarantee system related to surgical quality and safety” impacting “the public’s awareness of day surgery developing towards same-day surgery”, “the guarantee system related to surgical quality and safety” impacting “the ‘hospital-community’ integrated collaboration network”, “the public’s awareness of day surgery developing towards same-day surgery” impacting “the ‘hospital-community’ integrated collaboration network”, and “the ‘hospital-community’ integrated collaboration network” impacting “the iterative upgrade of day surgery” were all larger than 0.5, indicating strong influences between these factors, but the absolute value of standard path coefficient of the “hospital’s development brought by the transform of day surgery to same-day surgery” impacting “the guarantee system related to surgical quality and safety” was smaller than 0.3. Conclusion The hospital’s preliminary preparation, the guarantee system related to surgical quality and safety, the development of the “hospital-community” integrated collaboration network, and the public’s awareness are the probable factors influencing the iterative development of day surgery to same-day surgery.
The vigorous development of day surgery is crucial to alleviating the contradiction between supply and demand of medical and health care and improving the efficiency of medical and health resources in China. The current path dependence, policy inertia, and lack of coordination in the development of day surgery have brought a more severe test to the healthy and orderly development of day surgery in China, and the vulnerability in the development of day surgery has also emerged gradually. By examining the positive and negative experiences and lessons learned in the current development of day surgery, from the perspective of “structure-resource-information- society” subsystems, and based on the identification of key competencies in the collaborative development system for day surgery, this article indicates that the day surgery resilience is a composite system composed of spatial resilience, digital resilience, resource oriented resilience, institutional resilience and management resilience, and analyzes the implementation path of day surgery collaborative development system, providing a theoretical basis for the healthy and orderly development of day surgery in China.
Since 2015, when the day surgery mode was officially reckoned and supported by the National Health Commission, the day surgery model has entered the new period of rapid development. But at the same time, challenges in the vacancy of the evaluation indexes of the medical quality and safety of day surgery still pose obstacles to its growth. At present, there is no nationally unified evaluating index or appraising system for the day surgery-related medical quality and safety. In this paper, based on structure-process-outcome theory, the day surgery practice and involved researching literature were retrieved, reviewed, and analyzed. Also, the practice model at West China Hospital of Sichuan University (a pioneer day surgery hospital in China) was comprehensively compared with the National Clinical Improvement System. From the aspect of day surgery medical quality and safety evaluation indicators, it is hoped to provide an evidence-based method and evaluation of day surgery, and a theoretical basis for establishing policies and data reference.