Why are hospital Stays after Surgery so Short?

Recently my wife had a hip replacement. This was performed on a Monday morning. On Tuesday afternoon I was called to pick her up. Wow! Was my first reaction, my second was that, thankfully, I hadn’t had time to mess the house up. I decided to educate myself on why this phenomenon of, to me, startlingly short hospital visits was the new standard of care. The following is some of information I gleaned. 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. Obviously many surgical procedures are far improved a process that will continue. For instance when I was young I had a hernia repair. I was in the hospital a week and then had extensive instructions as to how to protect the surgical site. Today most hernia operations are out-patient procedures, performed laparoscopically. To add to the surgical techniques there have been huge improvement in anesthetics with many procedures done under short duration sedation instead of general anesthesia and their longer recovery times. Another trend is that doctors want their patients to be as ambulatory as possible in as short a time as possible. This promotes quicker recovery and less dependence on the nursing staff and well meaning relatives. Hospital depression is another factor. I am sure that if a perfectly healthy person lay in a hospital bed for a few days they would feel increasingly ill and unhappy. The hustle and bustle, interrupted sleep, noise, etc means that a hospital stay is, by no stretch of the imagination, restful. And now for the really big factor. GERMS! Bacteria! Viruses! There is almost no place you can imagine that has more pathogens and a larger variety of them than a hospital. It makes sense. People go to the hospital because they are really sick and despite the best efforts of the staff many of these germs are airborne. We’ve all heard of Staph infections, Mersa and so on. My wife’s doctor told her that she had a far better chance of getting an infection in the hospital than at home. So off we went and she’s doing just fine. Now the cynical will call my attention to the insurance issue. That’s a valid concern and a topic for another day.