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Research Letter
October 6, 2015

Return to Acute Care Following Ambulatory Surgery

Author Affiliations
  • 1Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, Rockville, Maryland
  • 2RAND Corporation, Santa Monica, California
  • 3Truven Health Analytics, Bethesda, Maryland
  • 4M. L. Barrett Inc, Del Mar, California
  • 5Department of Surgery, University of California David Geffen School of Medicine, Los Angeles
JAMA. 2015;314(13):1397-1399. doi:10.1001/jama.2015.12210

Two-thirds of operations are performed on an outpatient basis, yet little research has assessed their quality.1-4 Our population-based study found that 30-day revisits for clinically significant surgical site infections following ambulatory operations accounted for less than 15% of all-cause revisits to inpatient or ambulatory surgery settings.5

The reasons for other revisits and their relationship to the index operation are unknown. This study determined the rates of all-cause, unplanned revisits (ie, not for routine medical care) within 30 days of ambulatory surgery and whether revisits were related to the operation.

We performed a retrospective analysis of 6 low- to moderate-risk ambulatory operations spanning a range of specialties and complexity. We used the 2010-2011 Healthcare Cost and Utilization Project (HCUP) State Ambulatory Surgery and Services Databases, State Inpatient Databases, and State Emergency Department Databases for 7 states with unique, encrypted patient numbers (representing approximately one-third of the US population), allowing linkage of the ambulatory operations with 30-day postoperative, unplanned acute care revisits.6