RAPID HOSPITAL DISCHARGE FOLLOWING LAPAROSCOPY FOR ECTOPIC PREGNANCY - A PROMISE UNFULFILLED

This study was done to determine whether laparoscopy for ectopic pregn ancy in the United States is associated with rapid postoperative disch arge, defined as 2 days or less, and to estimate how often ambulatory treatment of ectopic pregnancy occurs without subsequent hospital admi ssion. We used the National Hospital Discharge Survey to estimate the frequency of ectopic pregnancy admissions, operations, and length of h ospital stays in 1990. We used the National Ambulatory Medical Care Su rvey to estimate the number, type, and disposition of office visits fo r ectopic pregnancy in 1990. According to National Hospital Discharge Survey data, tubal pregnancy led to an estimated 57,000 hospital admis sions in 1990. Most (70%) of the 26,000 patients treated with laparosc opy were in the hospital 3 days or more, and most (73%) underwent salp ingectomy. The number of ambulatory visits for ectopic pregnancy was t oo low to estimate reliably according to the standards of the National Center for Health Statistics. We found that laparoscopy was used freq uently for the treatment of ectopic pregnancy but was not associated w ith rapid postoperative discharge. Further research is needed to deter mine whether these findings persist and whether reimbursement incentiv es, patient preference, or problems with the diffusion of technology a re responsible.