The value in ambulatory vs inpatient surgery

Editor's Note

In this study, researchers from Brigham and Women’s Hospital and Harvard Medical School, Boston, find that ambulatory surgery offers significant cost savings and generally superior 30-day outcomes compared to inpatient surgery.

Of 73,724 patients having hernia repair, primary total or partial thyroidectomy, laparoscopic cholecystectomy, or laparoscopic appendectomy in either the inpatient or outpatient setting:

• approximately 87% were performed in the ambulatory setting
• surgical costs were significantly lower for ambulatory vs inpatient cases for all four procedures
• odds of having a 30-day readmission after thyroidectomy, hernia repair, and laparoscopic cholecystectomy were lower in ambulatory vs inpatient settings
• readmission rates after ambulatory vs inpatient laparoscopic appendectomy were comparable.

Facility fees appear to be a driving force behind rising healthcare costs, and inpatient surgery fees are significantly higher than ambulatory surgery fees, with ambulatory patients having better or comparable outcomes, the researchers say.