Inpatients require surgical procedures, raising the question of whether these procedures should be scheduled as elective or emergent. Traditionally, surgeries were deemed emergencies solely when there were physical, psychological, or rarely, spiritual imperatives, necessitating immediate action to avert irrevocable harm to patients’ bodies, minds, and souls. Now, the debate centers on whether surgical procedures can be considered emergencies to mitigate socioeconomic risks. These risks could lead to profound and lasting harm not only for patients but also for health care providers and systems. This is pertinent even in cases where non-physical, non-psychological, and potentially non-spiritual reasons are at play.
Socioeconomic factors among inpatients are varied. In a scenario where inpatient care is expedited, patients might cite socioeconomic reasons for remaining admitted while awaiting their preferred surgical providers’ availability. In a system with streamlined authorizations and reimbursements, providers and institutions may justify urgent procedures based on socioeconomic grounds. This approach could prevent needless delays in transitioning inpatients to outpatients while ensuring warranted surgeries are promptly performed.
Consideration must also be given to payment models. If bundled payments or capitations are in place, health care payers might prefer inpatient surgeries, as they often yield lower reimbursements than the same procedures performed on an outpatient basis.
The primary challenge is guaranteeing the availability of health care staff during after-hours and weekends. This is crucial for promptly scheduling and conducting surgeries on inpatients within 24 hours of unscheduled add-ons. This approach prevents undue prolongation of hospital stays and unnecessary increases in health care costs.
In essence, surgical procedures for inpatients can constitute socioeconomic health care emergencies, even in the absence of apparent physical, psychological, or spiritual urgencies.
Deepak Gupta is an anesthesiologist.