Ambulatory surgery in an HMO. A study of costs, quality of care and satisfaction

This study is a retrospective examination of data from a prepaid group practice that introduced a change in surgical services so that about 35 per cent of patients having surgery in the operating room were not admitted to the hospital. The study population is the membership of the Oregon Region of the Kaiser Foundation Health Plan for the period 1966 through 1974. The data come from 100 per cent of the hospital admissions and 100 per cent of the ambulatory (nonadmit) surgical procedures. This study examines the costs, quality of care, and satisfaction of providers and patients with ambulatory surgery. Cost savings for the ambulatory procedures averaged +192.19 per procedure (based on 1977 costs). National savings for 1977 were projected at +773,947,208. In addition, ambulatory surgery absorbed an increasing demand for surgical procedures without requiring additional hospital beds. No difference in quality of care were found for inpatients and ambulatory patients (both used the same operating rooms and staff), and both providers and patients were found to be very satisfied with ambulatory surgery services.