The impact of an ambulatory surgical service in a community hospital.

The purpose of this study was to quantify the savings accrued from shifting surgical cases from an inpatient to an outpatient setting. There was no increase in the total number of operations from 7952 in 1973 to 10,250 in 1987. The percentage of ambulatory procedures showed a continuous increase from 17.9% to 56.3%. The 15-year experience accumulated at this institution now exceeds 43,000 cases, with no mortality. The study closely examined hospital charges, not costs, for 2 months, which were then annualized. The calculated average savings per case was $2000 and 3.07 hospital days. The estimated savings for fiscal 1987 were $11.5 million and 17,726 hospital days. Based on this experience, the operation of an in-hospital ambulatory surgical unit is recommended as a cost-saving, safe, and efficient method of performing many surgical procedures.