FUNCTIONING AND WELL-BEING OF PATIENTS BEFORE AND AFTER ELECTIVE SURGICAL-PROCEDURES

BACKGROUND: Recent changes in health care delivery and financing have prompted interest in medical outcomes research. This study was perform ed to assess the effect of general surgical procedures on the health s tatus of patients over time. STUDY DESIGN: The functional health statu s of patients undergoing elective surgical procedures was measured pre operatively, in the immediate postoperative period, and three and six months after surgery. Complete data were collected for 82 patients pre senting to the general surgery service at the Ohio State University Me dical Center for symptoms related to gallbladder disease (21), hemorrh oids (10), inguinal and incisional hernias (37), and clinically severe obesity (14), The Short Form-36 health status questionnaire was admin istered before the surgical procedure, at the first postoperative visi t, and by telephone three months and six months following surgery. Hos pital records were reviewed following the procedures, and preoperative anesthesiologist's risk status, American Society of Anesthesiologists scores, and complications were noted. Patient satisfaction was assess ed using a questionnaire developed by Ohio State University. RESULTS: For all four elective procedures, a significant improvement in health status was demonstrated when preoperative function was compared to mea surements three and six months postoperatively. Improvement was signif icant in all eight categories assessed, encompassing physical, social, mental, emotional, and general health, and pain relief. Dramatic impr ovement was reported by patients undergoing Roux-en-Y gastric bypass f or clinically severe obesity. CONCLUSIONS: The Short Form-36 health st atus questionnaire proved to be a useful tool in assessing patient out comes following elective surgical procedures. The general health statu s assessment will be especially useful for documenting the effectivene ss of routine and innovative therapies.