Hospital-Based Ambulatory Surgery
Surgeries in Hospital-Based Ambulatory Surgery and Hospital Inpatient Settings, a statistical brief from the Healthcare Cost and Utilization Project, presents national data on surgeries performed in two hospital settings: hospital inpatient and hospital-based ambulatory surgery settings.
Ambulatory surgery, or outpatient surgery, is a planned operation for which the patient is not expected to be admitted to the hospital. Comparison of ambulatory surgery with inpatient surgery is essential for understanding utilization patterns for specific surgical procedures, including changing trends and estimates of total surgical volumes. As the number of surgical procedures capable of being safely performed in an ambulatory setting increases, comparisons of ambulatory surgery with inpatient surgery can also be useful in the evaluation of post-surgical complications, hospital cost savings, and patient experience of care surveys.
The analysis was limited to visits for an invasive surgery commonly performed for therapeutic purposes (i.e., to treat disease or injury); excluded were noninvasive surgeries and surgeries typically used for diagnostic or exploratory purposes (e.g., colonoscopy).
Highlights of Surgeries in Hospital-Based Ambulatory Surgery and Hospital Inpatient Settings
In 2014, 17.2 million hospital visits (ambulatory or inpatient) included invasive, therapeutic surgeries. Over half of these visits (57.8 percent) occurred in a hospital-owned ambulatory surgery setting, and the remaining (42.2 percent) were inpatient.
Private insurance was the primary expected payer for 48.6 percent of ambulatory surgery visits. Medicare was the most common payer among inpatient surgical stays (43.4 percent).
The following procedures were among the most common invasive, therapeutic ambulatory surgeries:
- Lens and cataract procedures (99.9 percent performed in ambulatory surgery settings)
- Excision of semilunar cartilage of knee (98.7 percent in ambulatory surgery)
- Tonsillectomy (95.6 percent in ambulatory surgery)
- Decompression peripheral nerve (95.2 percent in ambulatory surgery)
- Inguinal and femoral hernia repair (92.0 percent in ambulatory surgery)
- Incision or fusion of joint, destruction of joint lesion (80.4 percent in ambulatory surgery)
- Operating room procedures of skin and breast (78.5 percent in ambulatory surgery)
- Muscle, tendon, and soft tissue operating room procedures (71.9 percent in ambulatory surgery)
- Repair of diaphragmatic, incisional, and umbilical hernia (61.1 percent in ambulatory surgery)
- Cholecystectomy (60.8 percent in ambulatory surgery)
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