Return hospital visits and hospital readmissions after ambulatory surgery

Objective To determine the overall and complication-related readmission rates within 30 days after ambulatory surgery at a major ambulatory surgical center. Summary Background Data Currently in North America, 65% of the surgical procedures are carried out in ambulatory settings. The safety of ambulatory surgery is well documented , with low rates of adverse events during or immediately after surgery. The consequences of ambulatory surgery during an extended period, however, hav e not been studied extensively, Methods Preoperative, intraoperative, and postoperative data were collected on 17,6 38 consecutive patients undergoing ambulatory surgery at a major ambulatory surgical center in Toronto, Ontario. With the use of the database of the O ntario Ministry of Health, the authors identified all return hospital visit s and hospital readmissions occurring in Ontario within 30 days after the a mbulatory surgery. Return visits were categorized as emergency room visits, ambulatory surgical unit admissions, or inpatient admissions. The readmiss ions were categorized as those resulting from surgical, medical, or anesthe sia-related complications or those not related to the ambulatory surgery. Results One hundred ninety-three readmissions occurred within 30 days after ambulat ory surgery (readmission rate 1.1%). Six patients returned to the emergency room, 178 patients were readmitted to the ambulatory surgical unit, and 9 patients were readmitted as inpatients. Twenty-five readmissions were the r esult of surgical complications, and one resulted from a medical complicati on (pulmonary embolism). The complication-related readmission rate was 0.15 % (1 in 678 procedures). The complication rate was significantly higher amo ng patients undergoing transurethral resection of bladder tumor (5.7%). No anesthesia-related readmissions or deaths were identified. Conclusions The rate of complication-related readmissions was extremely low (0.15%). Th is result further supports the view that ambulatory surgery is a safe pract ice.