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Ambulatory surgery utilization by age level.

R J Lagoe, S E Bice and P B Abulencia

We compared ambulatory and inpatient surgery utilization by age level for procedures known to be frequently performed on an ambulatory basis. Our scope of data was the Crouse Irving Memorial Hospital in Syracuse, New York during 1984. The hospital operates one of the largest freestanding ambulatory surgery programs in the United States. The study included 8,348 ambulatory procedures, 42 per cent of all operations performed under the aegis of this institution. At the aggregate, the inpatient surgery included a somewhat lower proportion of young adults and a higher proportion of individuals aged 65 and over did outpatient surgery. For specific procedures, however, age distributions differed. Ambulatory procedures included lower percentages of elderly than did inpatient utilization for inguinal hernia repair, carpal tunnel release, destruction of larynx lesions, hernia repairs, destruction of skin lesions, and other operations, while ambulatory utilization for lens procedures included higher percentages of elderly patients than did inpatient utilization. Physician practice patterns also appeared to influence the setting of certain procedures. The study data suggested that persons involved in health planning should evaluate ambulatory surgery use on an age and procedure-specific basis, and utilization review should evaluate procedures on a case-by-case basis.

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