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Invited Commentary
March 2014

Home, Sweet Home, After Surgery

Author Affiliations
  • 1Department of Surgery, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco
JAMA Surg. 2014;149(3):251. doi:10.1001/jamasurg.2013.3845

After surgery, several factors influence when and where a patient is discharged. Patient-related factors include the patient’s general condition, ongoing needs, and comfort level managing those needs. The patient’s social network of family and friends also has an important role. A robust and mature social network might make early discharge to home a possibility. Other factors are surgeon and hospital experience with the routine postoperative course after a complex surgical procedure, whereby the use of critical pathways may result in early discharge to home.1 Conversely, surgeon and hospital inexperience might underlie lengthy hospital stays and discharge to skilled facilities. Moreover, a complex interplay of factors, such as the availability, quality, cost, and insurance coverage of home health care and skilled facilities, might also affect discharge time and destination.

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