Evaluation of Patients Admitted in the Department of Plastic and Re-Constructive Surgery at a Tertiary Care Institute of North India

Nowadays, majority of hospitals are having queuing and waiting time problems. Waiting time for elective care is defined as the time that elapses between firstly the physicians decision to admit a patient for elective surgery following clinical assessment and secondly the date of hospital admission. This study was conducted in the department of plastic and re-constructive surgery at the SHER-E- KASHMIR INSTITUTE OF MEDICAL SCIENCES (SKIMS), Soura. The study was conducted for a period of one year from 1st October 2013 to 30th September 2014. It was a prospective observational study carried out on the patients admitted in the ward of plastic and re-constructive surgery. The study was done based on the interviews from relevant informants, study of record and observations made by the researcher. Outpatient cards and in-patient case sheets of the admitted patients to ascertain the waiting time from the date of decision of surgery to actual date of surgery was calculated. Interviews were conducted on relevant stake-holders which included resident doctors, patients and attendants of the patients. A total of 2238 patients were included in the study with mean age of 26 years, with 60.9 % as males. About 62.2 % belonged to rural areas. Mean Length of stay of road traffic accident was 9.97 days, for bear maul it was 9.68 days, for machine cut mean length of stay was 10.69 days, for Post burn contracture it was 11.58 days and in squamous cell carcinoma face it was 9.22 days. Out of the total 2238 patients, 1629 recovered, 54 had amputation of arm, 18 had nerve loss injury, 63 had face deformity and 9 died. It was inferred that the maximum number of cases admitted were those of road accidents, trauma, burns and animal infected injuries. It was seen that mean wait time was 42.88days with cases like cleft palates, palatal fistula and contractures having an extended wait times of more than 45 days. However, cases like Road traffic accidents, burns, fall from height, carcinoma breast were treated on emergency grounds. Also patients from rural areas had a mean wait time of 46.35 days while those in urban areas had a mean wait time of 37.18 days.