Variation in hospital stay after inguinal herniorrhaphy.

A study was carried out of 1086 men aged 16-65 inclusive who were admitted under nine consultants to eight hospitals in Wessex for elective repair of an inguinal hernia. The mean postoperative stay was 5.7 +/- SD 2.7 days. For different consultants operating at any one hospital the mean postoperative stays were similar, whereas for consultants who operated at more than one hospital they were significantly different. The postoperative stay was also significantly related to the size of the hospital, development of postoperative complications, time spent on the waiting list, type of repair used, bilateral herniorrhapy, and the use of convalescent facilities. The hospital therefore appears to exercise a greater influence in determining the mean postoperative stay than does the individual consultant.     

Advice to a Moscow children's hospital.

At the request of the largest children''s hospital in Moscow, McKenzie and colleagues made recommendations for improving the service. Restrictions on visiting and fears of contracting illness from non-disposable needles have discouraged the local population from using the hospital. Consequently the hospital is underused and overstaffed. Serious shortages of drugs and surgical supplies compromise care. Fundamental changes are needed in nursing and postgraduate education. The authors encouraged their Russian colleagues to address the health care needs of their local population and to develop family centred care, and they offered training in London.