Authors' objectives:

This report considers the medical and non-medical factors which have lead to the increase in the number of surgical interventions undertaken in an outpatient setting. The second section of the report evaluates the clinical and economic consequences of transferring surgery from inpatient to outpatient care.

Authors' results and conclusions: The development of ambulatory surgery is due to advances in anaesthetics and medical technology, and financial constraints on health services. Bed closures and pressure to reduce hospital waiting lists have been major factors in the switch from conventional surgery to ambulatory surgery. There appear to be no significant differences in results between ambulatory surgery and inpatient care for the treatment of inguinal hernias and cataracts and breast tumour removal. There is insufficient literature on the treatment of carpal tunnel syndrome to enable a comparison to be made. Ambulatory surgery uses fewer resources in terms of indirect costs than conventional surgery. Little information is available on indirect costs or cost-effectiveness. Factors which need to be taken into account when transferring surgery to an outpatient setting include patient eligibility, safety (particularly potential post-operative complications), and individual patient preference. Patient care needs to be modified and adapted, and all member of the health care team should be involved in this process. The relationship of the health care setting with other health care establishments, such as other private/state hospitals needs to be taken into consideration.

Authors' recommendations: Published studies show that ambulatory surgery can be as effective as conventional surgery for certain interventions. Itreduces potential surgery complications and uses fewer resources. This report identifies the important factors which should be taken into consideration when transferring surgical activity from an inpatient to an outpatient setting.

Authors' methods: Review, Economic evaluation

Project Status: Completed

URL for project: http://www.has-sante.fr/

Year Published: 1997

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: L'Agence Nationale d'Accreditation d'Evaluation en Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: sh.leerobin@has-sante.fr

Contact Email: sh.leerobin@has-sante.fr

Copyright: Agence Nationale d'Accreditation et d'Evaluation en Sante, 1997