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Related Experiment Video

Updated: Jun 29, 2025

Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
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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.

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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.

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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.