Referral System of Appendicitis within Nakhon Ratchasima Province of Debaratana Nakhon Ratchasima Hospital

Abstract

Background: Acute appendicitis is the most common surgical emergency. The only one treatment is surgery. And the best time for operation is prior the rupture of the appendicitis. Nakhon Ratchasima province is heavily populated. Formerly the patients would be referred to surgery at Maharat Nakhon Ratchasima Hospital which was always crowd with various patients, so the appendicitis patients could not access the sufficient care and some patients developed some complications or even passed away due to delayed operation. The Ministry of Public Health established Debaratana Nakhon Ratchasima Hospital for reducing the congestion of patients of Maharat Nakhon Ratchasima Hospital and promoting it to be the center of appendectomy of Nakhon Ratchasima province. Objective: To reduce the waiting list for surgery in patients especially with appendicitis in the hospital. Method: To consult, plan and set the new system to accept the patients with appendicitis from every hospital in Nakhon Ratchasima province for faster operation. In the old system, only the patients from 8 districts were accepted. Results: The patients with appendicitis achieved more convenient and faster operation without serious complication. The time interval for waiting operation was 4-6 hours. The numbers of refered cases for appendectomy in each fiscal year from 2012 to 2015 were 68, 467, 737, and 907 with 624 in the year 2016 (only Oct.-Apr). The potentiality of the hospital was considered improved.