USE OF OUTPATIENT PREOPERATIVE EVALUATION TO DECREASE LENGTH OF STAY FOR VASCULAR-SURGERY

Interventions that decrease perioperative length of stay can result in considerable cost-savings. This study assesses the impact of same-day admission using outpatient preoperative evaluation on the lengths of stay and hospital costs for patients who underwent carotid endarterect omy (CEA) or lower extremity revascularization (LER). Patient characte ristics and length of stay were compared for two 1-yr periods before a nd after outpatient preoperative evaluation had been implemented. Ther e were no significant differences before and after the initiation of o utpatient preoperative evaluation in the CEA and LER groups in mean ag e and ASA physical status distributions. The average preoperative leng th of stay decreased significantly from 7.0 to 1.9 days in the CEA gro up and from 9.0 to 2.8 days in the LER group. This reduction in the le ngth of stay was associated with a cost-savings of $900 per patient an d did not have an adverse effect on patient outcome. We conclude that outpatient preoperative evaluation clinics reduce the cost and length of stay in vascular surgery patients. Implications: We found that outp atient preoperative evaluation and same-day admission were associated with a decrease of 4.5 days in the preoperative length of stay for car otid endarterectomy and lower-extremity revascularization. This was no t accompanied by increased mortality and led to hospital cost-savings of approximately $900 per patient.