ELECTIVE SURGERY EFFECTIVE FOR PATIENTS, STUDY FINDS

COLUMBUS, Ohio -- People who undergo elective surgery to treat such common health problems as hernias and hemorrhoids experience significantly better physical and mental health as a result, a new study suggests.

The study, conducted at Ohio State University, is the first to take a "before and after" look at the effectiveness of elective surgery. Researchers found that at three and six months after surgery for gall bladder disease, hernia, hemorrhoids or clinically severe obesity, patients had significantly fewer limitations in their physical and social activities because of health or emotional problems, as well as improved vitality, general health and mental health.

"We were a bit surprised to find such improvements, given that there's always controversy about the need for and effectiveness of elective surgery," said Patricia C. Temple, clinical associate professor of pediatrics and health servicesmanagement and policy at Ohio State University and lead author of the study. The study was published in the July issue of the Journal of the American College of Surgeons.

Temple conducted this research with Beth Travis, an undergraduate student; Larry Sachs, associate professor of allied medical professions and family medicine; Stephen Strasser, associate professor of health services management and policy; Patricia Choban, assistant professor of surgery; and Louis Flancbaum, associate professor of surgery and anesthesiology, all from Ohio State.

The study involved 82 patients who had gall bladder, hemorrhoid, hernia or gastric bypass surgery at the Ohio State University Medical Center between October 1992 and December 1993. The researchers asked each patient to complete a 36-item questionnaire about health status at four different points in time: before surgery, immediately after surgery, three months later and six months later. The researchers also collected information about each patient's anesthesia risk, complications during hospitalization and satisfaction with the hospital stay.

They found that all four elective procedures resulted in significantly improved health status for patients -- that is, better self-reported physical, social, mental, emotional and general health and pain relief. Results show that patients' physical and social functioning were the most impaired before surgery and were the most dramatically improved three months later. In general, improvements leveled off at six months after surgery.

More specifically, results show that patients with severe obesity had significantly more physical limitations before surgery than any other patient group. However, unlike the other patient groups, these patients continued to experience improvements in health status even six months after surgery.

"Those cases showed the most dramatic improvement," Temple said. "At the end, they almost felt like they were new people."

Temple said these results should be helpful to both patients considering elective surgeries and health insurance providers considering whether or not to cover them.

"I think it helps patients to know that if they go through these elective surgeries -- even if they're not feeling 'bad' at the time -- they're likely to see dramatic improvements in health," she said.

Also, Temple said, these results are important evidence that elective procedures -- even newer ones such as the gastric bypass surgery for severe obesity -- do result in better health for patients.

"Gastric bypass surgery is a relatively new technique that some insurers will not cover," Temple said. "We hope our results and future studies using the health status questionnaire as an evaluation tool will help insurance providers settle the controversies about whether to cover a procedure or not."

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Contact: Patricia C. Temple, (614) 293-2054

Written by Kelly McConaghy Kershner, (614) 292-8308