Effect of return hospital visits on economics of ambulatory surgery

Imasogie, Ngozi; Chung, Frances

doi:10.1097/00001503-200110000-00020

Cited by 11 publications

(8 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2 Several studies have looked at patient safety markers to assess outpatient surgical outcomes. [3][4][5] Unanticipated admission has been suggested as such a marker as well as a way to identify unsuitable ambulatory surgical candidates. 6,7 Unanticipated admissions result in inflated costs to an already stressed healthcare system.…”

Section: Résumémentioning

confidence: 99%

See 1 more Smart Citation

Predictors of unanticipated admission following ambulatory surgery: a retrospective case-control study

Whippey

Kostandoff

Paul

et al. 2013

Can J Anesth/J Can Anesth

100

View full text Add to dashboard Cite

Purpose The primary objectives of this historical casecontrol study were to evaluate the incidence of and reasons and risk factors for adult unanticipated admissions in three tertiary care Canadian hospitals following ambulatory surgery. Methods A random sample of 200 patients requiring admission (cases) and 200 patients not requiring admission (controls) was taken from 20,657 ambulatory procedures was identified and compared. The following variables were included: demographics, reason for admission, type of anesthesia, surgical procedure, length of procedure, American Society of Anesthesiologists' (ASA) classification, surgical completion time, pre-anesthesia clinic, medical history, medications (classes), and perioperative complications. Multiple logistic regression analysis was used to assess factors associated with unanticipated admissions. ResultsThe incidence of unanticipated admission following ambulatory surgery was 2.67%. The most common reasons for admission were surgical (40%), anesthetic (20%), and medical (19%). The following factors were found to be associated with an increased risk of unanticipated admission: length of surgery of one to three hours (odds ratio [OR] Author contributions Amanda Whippey, Greg Kostandoff, James Paul, Jinhui Ma, and Lehana Thabane helped design the study and write the manuscript. Amanda Whippey, Greg Kostandoff, and James Paul helped conduct the study. Heung Kan Ma helped in data collection, and Jinhui Ma and Lehana Thabane helped analyze the data. James Paul is the author responsible for archiving the study files. Amanda Whippey, Greg Kostandoff, Jinhui Ma, James Paul, Lehana Thabane, and Heung Kan Ma have seen the original study data. Amanda Whippey, Greg Kostandoff, Jinhui Ma, James Paul, and Lehana Thabane reviewed the analysis of the data. 0.08 to 0.33), and dental/ear-nose-throat surgery (OR 0.32; 95% CI 0.13 to 0.83) when compared with general surgery. Other comorbid conditions did not impact unanticipated admission. Conclusion Unanticipated admission after ambulatory surgery occurs mainly due to surgical, anesthetic, and medical complications. Length of surgery more than one hour, high ASA class, advanced age, and increased BMI were all predictors. No specific comorbid illness was associated with an increased likelihood of unanticipated admission. These findings support continued use of the ASA classification as a marker of patient perioperative risk rather than attributing risk to a specific disease process. RésuméObjectif Les objectifs primaires de cette e´tude cas-te´moin historique e´taient d'e´valuer l'incidence ainsi que les raisons et les facteurs de risque des admissions non anticipe´es de patients adultes dans trois hôpitaux canadiens de soins tertiaires apre`s une chirurgie ambulatoire. dentaire / oto-rhino-larynge´e (ORL) (RC 0,32; IC 95 % 0,13 a`0,83) par rapport a`une chirurgie ge´ne´rale. Aucun impact sur les admissions non anticipe´es n'a e´te´observeá vec d'autres comorbidite´s. Conclusion Les admissions non anticipe´es apre`s une chi...

show abstract

Section: Résumémentioning

confidence: 99%

“…6,7 Unanticipated admissions result in inflated costs to an already stressed healthcare system. 3,8 In the USA and the UK, the incidence of these unanticipated admissions ranges from 0.9-9.4%. 7,9,10 Previously, urological surgery, duration of procedure, and sex were associated with unanticipated admissions.…”

Section: Résumémentioning

confidence: 99%

Predictors of unanticipated admission following ambulatory surgery: a retrospective case-control study

Whippey

Kostandoff

Paul

et al. 2013

Can J Anesth/J Can Anesth

100

View full text Add to dashboard Cite

show abstract

“…In association with ambulatory surgery, hospital readmission is defined as an ambulatory surgical patient requiring inpatient admission following discharge from an ASU due to complications [53,54]. The readmission rate after ambulatory surgery is between 1 and 3% [53][54][55].…”

Section: Return To Hospital and Readmissionmentioning

confidence: 99%

Outcomes in day surgery

Shnaider

Chung

2006

Current Opinion in Anaesthesiology

Self Cite

113

View full text Add to dashboard Cite

show abstract

“…94 The rate of unanticipated hospital admission from the ASU is considered an index of quality of care. In most centres, the rate averages 1-2%.…”

Section: Unanticipated Hospital Admissionmentioning

confidence: 99%

“…In association with ambulatory surgery, hospital readmission is defined as an ambulatory surgical patient requiring inpatient admission following discharge from an ASU due to complications. 94 The readmission rate after ambulatory surgery is between 1-3%. 105,106 It is expected that more admissions will be associated with return hospital visits occurring within 24 hr of discharge than after 24 hr.…”

Section: Readmission After Ambulatory Surgerymentioning

confidence: 99%