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Outpatient surgery benchmarks and practice variation patterns: case controlled study
Chi Zhang1,2, Omair Shariq2,3, Katherine Bews2
1Department of Surgery, Mayo Clinic Arizona, Phoenix, Arizona.
International Journal of Surgery (London, England)
|March 25, 2024
Summary
Outpatient surgery generally has fewer complications than inpatient surgery for most procedures. However, variations in hospital practices may affect outpatient surgery rates and optimal patient selection.
Area of Science:
- General Surgery
- Health Services Research
Background:
- Lack of national benchmarking data hinders comparison of outpatient surgery outcomes.
- Hospitals and surgeons need data to guide the transition to outpatient procedures.
Purpose of the Study:
- To compare postoperative outcomes between inpatient and outpatient general surgery.
- To assess practice variations in outpatient surgery rates across institutions.
Main Methods:
- Analysis of 14 common general surgery operations from the ACS-NSQIP database (2016-2020).
- Comparison of complications and readmissions for inpatient versus outpatient procedures.
- Multivariable analysis adjusting for patient comorbidities and institutional practice variation.
Main Results:
- Fewer complications observed in 13 of 14 procedures for outpatient surgery (P <0.01).
- Minimally invasive adrenalectomy showed no significant difference in complications (P =0.61).
- Multivariable models confirmed lower odds of adverse events with outpatient surgery, except for MIS adrenalectomy.
Conclusions:
- Institutional practice patterns influence national variation in outpatient surgery rates.
- Current data does not support expanding outpatient surgery to less optimal candidates.
- Addressing practice variations could improve outpatient surgery utilization.
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