Study of accessibility costs and satisfaction comparing a MAS unit incorporated in a Hospital versus a theoretical model in a peripheral centre

Geographical barriers are a determining factor in the accessibility of Hospital health care, and structural changes to improve geographic accessibility must be introduced. The purpose of this study is to compare accessibility costs and the level of satisfaction obtained in an adapted Specialist Centre with a peripheral MAS (Major Ambulatory Surgery) Unit, with an already existing one incorporated into the Virgen de la Luz Hospital (Cuenca, Spain) to obtain quality health care in the sub-population nearest the peripheral Centre. A study was made on a comparison of the costs attributable to accessibility of 133 patients operated on due to hernia disorders in 2008 in the Cuenca Hospital of Castille-La Mancha Health Service (SESCAM), and who lived in its health area. These were compared using a simulation study for an ambulatory surgical Centre, functionally operational, but with no Major Ambulatory Surgery activity nearest to this patient population. The opinions of the patients and the increased cost-effectiveness for each alternative proposal were studied. The accessibility cost, taking into account the theoretical use of the Ambulatory Centre would be 208,028.09 € and the real costs of the Hospital were 209,088.94 €, with a minimum difference between the two of 1,060.85 €, assuming similar clinical results. Although there are no significant differences in accessibility costs by using an ambulatory surgery Centre compared to the Hospital, a special assessment of the use of the former is important, expressed in the satisfaction of the patients.