Electronic Referral and Booking of Outpatient Day Case Surgery Compared With Traditional Referral Routines.

Study Overview
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Brief Summary
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We want in this study to investigate the cost-effectiveness and waiting time of direct electronic referral and booking of outpatient surgery compared to the traditional patient pathway where the patient is seen at the outpatient clinic prior to surgery.

Detailed Description
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Waiting time from referral to day case outpatient surgery is unacceptable long. In Norway it is as much as 48 weeks for common conditions like gallstones, inguinal hernia and sinus pilonidalis. Electronic standardised referrals sent by the Norwegian Healthcare Network, and booking of surgery by the general practitioner might be a way to reduce the waiting time and increase the cost effectiveness of outpatient surgery. The trial is designated as a randomized controlled trial were selected patients (inguinal hernia, gall stone disease and sinus pilonoidalis) referred to the university hospital, were either randomized to direct electronic referral and booking for outpatient surgery (one stop), or using the traditional patient pathway where all patients are seen at the outpatient clinic several weeks before surgery.

Official Title
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Costs-effectiveness and Waiting Time for Direct Electronic Referral and Booking of Outpatient Day Case Surgery Compared With Traditional Referral Routines. A Randomised Controlled Trial

Conditions
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Referral and Consultation, Telemedicine, Surgery, Outpatient, Surgery, Day, Medical Records Systems, Computerized, Health Services Research, Health Care Surveys

Intervention / Treatment
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* Behavioral: one stop (Electronic standardised referrals and appointment bookings)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients were eligible if they were diagnosed by their GP for an inguinal hernia, sinus pilonidalis or gallstone disease which require surgical treatment. Exclusion Criteria: Patients with medical conditions making them unfit for outpatient surgery admitted to the surgical department prior to surgery are not eligible
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: 1<br>The one stop strategy is a set of interventions directed at GPs referring to the University Hospital. The interventions include: Guidelines for referral, standardised electronic referrals, booking for outpatient surgery and a patient information form. | Behavioral: one stop (Electronic standardised referrals and appointment bookings)<br>* The one stop strategy is a set of interventions directed at GPs referring to the University Hospital. The interventions include: Guidelines for referral, standardised electronic referrals, booking for outpatient surgery and a patient information form.<br>|
| No Intervention: 2<br>Patients in the control group are randomised to use the regular patient pathway prior to day case outpatient surgery. All these patients are referred to the surgical outpatient clinic. At the outpatient clinic patients are examined by a surgeon and indications for surgery is decided by the surgeon. If indicated, patients are then referred to outpatient surgery and the surgical procedure is performed several weeks after the examination. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| waiting time |  | one year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cost effectiveness |  | one year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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One-Stop, Public Health Research, Delivery of Health Care/*standards, Evaluation Studies, Referral, Surgery, Outpatient, Surgery, Day, Telemedicine