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Updated: Sep 8, 2025

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Variations in the Use of Outpatient Surgery.

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Geographic location significantly impacts outpatient surgery rates across the US, with hospital region being the primary driver of variation. Addressing these disparities can optimize resource utilization and improve surgical care delivery.

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Area of Science:

  • Health Services Research
  • Surgical Quality Improvement
  • Health Economics

Background:

  • Variation in outpatient surgery rates exists nationally.
  • Understanding factors driving this variation is crucial for quality improvement and resource optimization.

Purpose of the Study:

  • To explore variations in outpatient surgery utilization.
  • To identify patient, geographic, and hospital factors associated with these variations.

Main Methods:

  • Retrospective cross-sectional study using administrative claims data (OptumLabs Data Warehouse).
  • Inclusion of adult patients undergoing 10 specific general, urological, or gynecological operations (2015-2021).
  • Multilevel logistic regression to assess variation by hospital characteristics and census division, adjusting for patient factors.

Main Results:

  • Outpatient surgery was performed in 72.3% of 456,954 patients.
  • Significant variation in outpatient surgery likelihood by hospital census division was observed for all 10 operations.
  • Hospital geography was the primary contributor to variation in outpatient surgery for 8 of 10 procedures.
  • Larger hospitals (≥400 beds) showed decreased odds of outpatient surgery for several procedures.
  • Residency programs influenced outpatient surgery odds, increasing for some procedures and decreasing for others.

Conclusions:

  • Significant geographic variation exists in US outpatient surgery rates, primarily driven by hospital location.
  • These findings highlight opportunities to address disparities and improve the efficiency of surgical care delivery.
  • Further research into regional practice patterns can inform quality improvement initiatives.