Written by
Megan Adendorff
*This article was originally published in Afrikaans in “Die Burger” on 17 April 2026. This translation was done independently of “Die Burger” and Megan Adendorff.
Procedures that have previously required hospitalisation for multiple days can now be completed within a few hours – admission and discharge on the same day – a change that is growing the role of day hospitals in South Africa’s healthcare system.
According to Tharina Smith, Executive Officer of the Day Hospital Association of South Africa, advances in medical technology, anaesthesia and pain management have contributed to patients being discharged home safely after surgery. Smith notes: “It is about providing the right care, in the right place, for the right patient”.
The purpose of private day hospitals is not to replace acute hospitals, but to supplement the healthcare system by providing a suitable environment for selected procedures at a cost-effective rate.
Day hospitals are set up for planned procedures where patients are discharged on the same day.
“Day hospitals offer a focused, more affordable alternative for the appropriate procedures, while more complex and high-risk patients are still treated in acute hospitals”, says Smith.
Day hospitals handle a wide range of procedures, including cataract surgery, endoscopic procedures, ear, nose and throat procedures, orthopaedics, dental and maxillofacial surgery, gynaecology, urology, dermatology, and general surgery.
According to Smith, day hospitals give patients peace of mind that their planned operations will not only be performed safely, but also completed without unnecessary or extended waiting periods.
“Patients suitable for the day hospital procedures can safely be discharged on the same day” she says.
This is how day hospitals work
Not every patient or procedure is suitable for a day hospital.
Access to day hospitals means the patient has already been referred by a GP to a specialist for a procedure that is suitable for a day hospital.
“Patients will usually be admitted a few hours before a procedure, operated on, and will be discharged after their procedure when the treating doctor is satisfied that they are stable – typically within a few hours after the operation,” says Smith.
There are about 145 private day hospitals in South Africa, of which 65 independent facilities are represented by the Day Hospital Association of South Africa. In the Western Cape, there are currently 18 independent day hospitals that form part of the association.
Day hospitals work according to scheduled operating lists, without the interruption of emergencies, which makes a structured and predictable workflow possible.
“Because procedures are planned and elective, this supports efficient patient flow and time management,” says Smith.
Patients receive care from a dedicated team that includes specialists, anaesthetists and trained theatre and recovery staff, all with specialised training in their respective fields.
The cost-effectiveness of this model is largely due to efficiencies such as no overnight stays, smaller and more focused facilities, and no extra burden of maintaining emergency or intensive care units.
“This helps to limit costs for patients and medical schemes, which is important in a time of healthcare costs spiralling out of control in South Africa,” she says.
Day hospitals have modern operating theatres, technology and emergency equipment that are the same as those of acute hospitals.
“The difference lies in focus – day hospitals are smaller and more specialised, but definitely not sub-standard or less capable,” says Smith.
Day hospitals also play a role in elective surgery and help to reduce pressure on acute hospitals.
Benefits for patients
The safety of patients remains important to members of the Day Hospital Association of South Africa and is ensured through strict selection, planned procedures, monitoring and clinically controlled discharge.
“Patients are only discharged when they are clinically stable and receive clear instructions for recovery at home,” says Smith.
Another advantage is the lower risk of hospital-related infections due to shorter stays and limited exposure to ill, long-term patients.
The recovery can also be viewed as more comfortable; instead of being in a hospital, they can enjoy the familiar environment and all their comforts at home. It remains, however, of the utmost importance that careful patient selection and pre-operative planning are followed to ensure safety and optimal outcomes.
Day hospitals work closely with specialists and anaesthetists to coordinate care before, during and after procedures. However, should an emergency arise, day hospitals are equipped to manage the emergency and to arrange for the safe transportation to an acute facility if needed.
Medical schemes recognise the model and encourage the use of day hospitals for suitable procedures.
“Medical schemes see day hospitals as a cost-effective and clinically appropriate option for suitable procedures,” says Smith. “It forms part of a broader effort to make healthcare more sustainable.”
The schemes also use benefit structures to encourage patients to use day hospitals when it is clinically appropriate.
Day hospitals comply with the same regulatory and clinical standards as acute hospitals.
“There is no difference in the standards expected of us,” emphasises Smith.
“We must meet the same accreditation, follow the same regulations and protocols and achieve the same quality standards.”
Staff also receive ongoing professional development to keep up with the latest developments in day surgery and patient care.
“Our staff undergo the same thorough training as their counterparts in acute hospitals. The difference is that they specialise in day procedures and understand the unique requirements thereof.”
“Patients experience the service as predominantly positive, especially because they can go home the same day as well as the small family type atmosphere compared to larger hospitals The shorter stay also means that patients are less anxious and can return to their normal routine more quickly, which contributes to better overall satisfaction,” says Smith.
“The smaller environment often feels more personal and less overwhelming.”