ABSTRACT Background Hernia repair can safely be provided as a same‐day procedure. However, despite advice from published guidelines, previous analyses of Australian data have shown low rates of same‐day surgery in private hospitals for hernia repairs. Methods This study used aggregated administrative data for Medibank‐insured patients treated in Australian hospitals between 1 January 2015 and 31 December 2024 for surgical repairs of inguinal, femoral, or umbilical hernias to analyse trends in same‐day services. Results The proportion of hernia procedures performed as same‐day separations increased over time, rising from 22.7% in 2015 to 31.0% in 2024 ( p < 0.001). The average length of stay (LOS) among patients requiring overnight admission remained stable (1.26 days in 2015; 1.23 days in 2024). Same‐day separations were most common for umbilical repairs (47.5%), compared with femoral (23.7%) and inguinal repairs (22.0%). Female patients had a higher proportion of same‐day separations (29.5%) compared with male patients (25.8%, p < 0.001), but a higher average LOS (1.31 days, p < 0.001). The use of same‐day surgery varied across hospital locations. Conclusions Despite a groundswell of evidence, changes in surgical practice to adopt same‐day hernia repair for privately‐insured patients are happening very slowly and are well below the recommended target of 70%–80%. The rise in same‐day separations appears to reflect greater use of day‐case pathways rather than shorter hospital stays among patients requiring admission overnight. Variation across locations suggests opportunities to improve consistency in care delivery through system‐level changes, and for same‐day hernia repair to become routine practice across all hospitals in Australia.
ABSTRACT Introduction Orthopaedic surgery remains Australia's least gender‐diverse medical specialty. Despite extensive global literature on barriers to gender equity, no prior study has applied an established gender bias instrument to assess gender bias in Australian orthopaedics. Methods A national mixed methods study was conducted comprising a cross‐sectional survey and semi‐structured interviews. Eligible participants included all practising orthopaedic surgeons and trainees in Australia. The survey utilised an adapted version of the 47‐item Gender Bias Scale and was distributed via the Australian Orthopaedic Association and departmental mailing lists. Interviewees were recruited from survey volunteers and were undertaken to provide explanatory depth and contextualisation to the survey findings. Results 163 orthopaedic surgeons and trainees (85 male, 78 female) completed the survey. Female participants were significantly more likely to report barriers across the male culture and unequal standards domains. Twenty of the 47 GBS items showed significant gender differences ( p < 0.05). Ten follow‐up interviews were conducted. Contextualised insights explained the implications of male‐dominated culture for women and added nuance to themes including salary inequality and family life. Conclusion This study presents Australian data on key barriers to gender equity in orthopaedics, providing an evidence base for future policy. Achieving progress will require more than increasing representation. It will take thoughtful policy and continuous effort to address structural and attitudinal barriers.
