, Volume 2, Issue 2, pp 121-126
Date: 28 Jul 2006

Are Ambulatory Surgical Patients as Healthy as We Think? Using a Self-Reported Health Status Questionnaire to Identify Unsuspected Medical Comorbidities

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Introduction

Over the last 30 years, there has been a strong trend toward the performance of surgery in the ambulatory, outpatient setting. In 1982, of all operations performed in the United States, 20% were performed as outpatient procedures; by 1995, this figure had increased to 60% [1]. This trend has been particularly evident in the field of orthopedic surgery. For example, at Hospital for Special Surgery, which focuses exclusively on musculoskeletal disease, there were over 7,000 ambulatory surgeries (AMS) performed in 2004. This is in contrast to ∼4,700 outpatient procedures performed in 1996.

Although economically advantageous, AMS challenges the system of care in a variety of ways, perhaps most significantly in the arena of preoperative medical evaluation. Medical consultations on these patients are usually ordered at the discretion of the attending surgeon. In general, patients undergoing AMS are younger and healthier than those being admitted for inpatient procedures. However, ...