SURGERY The following 17 indicators concern surgery. Seven of them are new this year. One indicator reflects outcomes for bariatric surgery, which is increasingly performed in Sweden. In addition to medical outcomes, two of the indicators look at costs per operation.
143 Reoperation for Inguinal Hernia Inguinal hernia operations represent the most common general surgical procedure in Sweden. More than 17 000 operations are performed every year. Men, who are much more likely than women to develop an inguinal hernia, account for 92 per cent of all operations. Almost 16 000 operations were reported to the Swedish Hernia Register in 2011. Successful surgery is an uncomplicated procedure requiring approximately one week of sick leave and normally followed by freedom from symptoms. But surgery can also lead to recurrence of the hernia and chronic pain conditions or feelings of discomfort. There was a time when close to 20 per cent of all patients had a recurrence of hernia. Newer surgical methods and materials have sharply reduced the recurrence rate. The indicator estimates the odds of not needing a reoperation within five years – “survival” in accordance with a Kaplan-Meier analysis. The comparison was based on more than 76 000 operations reported to the Swedish Hernia Register in 2007– 2011. The location of the clinic, not where the patient was living, determined how an operation was classified. Figure 143 reveals various minor differences among the counties. Almost 98 out of every 100 patients nationwide did not have to undergo a reoperation within five years. There were major variations from hospital to hospital. The differences among
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Figure 143 Sweden
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Percentage of inguinal hernia repair cases not reoperated on within five years. Source: Swedish Hernia Register
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QUALITY AND EFFICIENCY IN SWEDISH HEALTH CARE 2012