Ambulatory surgery in Portugal The 2003 APCA report

Day surgery has began in Portugal around the 90 decade of last century. Although publishing some documents and guidelines [1], the Portuguese Government had never define clear health policies in order to develop day surgery programmes. On the contrary, all the legislation and financing regulations published were restrictive and non-competitive from the ambulatory surgery point of view. In fact, different Governments from the last 6 years agreed on the important clinic, economical and social advantageous of day surgery on the Portuguese National Health Service (NHS). However, we observed a stagnant evolution of day surgery in Portugal, growing up from 5.5 to 7.2% of all non-emergent surgery from 1999 to 2001, respectively. Our 2001 National Survey on Ambulatory surgery [2], showed that 20,870 major surgeries were performed on a day surgery basis, on a total of 290,597 non-emergent surgeries. This figure represented an increase of 1.7% when we compare with the first National Survey done in 1999 (Table 1) [3]. Although the majority of the public hospitals have insignificant day surgery programmes, there are few hospitals where this regimen represents more than 30% of all non-emergent surgery [4]. Going back to some data published by De Lathouwer and Poullier in 1998 [5], we noticed that for a 18 basket procedures selected as the most significant for ambulatory surgery, Portugal had a rate of 9.9% (7,693 in a total of 77,394 surgeries), far beyond all other countries involved in the study. However, when we compare these numbers with the results of our 2001 National Survey, we realise that there was a great increase in day surgery in Portugal on that period of time: we found a rate of 15.7% in 2001 for the same