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U.S. outpatient surgery passes inpatient, to 53 million a year

Surgical tools illuminate the room during an outpatient cataract surgery at St. Luke’s Cataract & Laser Institute in Tarpon Springs. Lens and cataract surgeries top the list of most common outpatient procedures.

BRENDAN FITTERER | Times

Surgical tools illuminate the room during an outpatient cataract surgery at St. Luke’s Cataract & Laser Institute in Tarpon Springs. Lens and cataract surgeries top the list of most common outpatient procedures.

Every day, dozens of people visit the Carol and Frank Morsani Center for Advanced Health Care at the University of South Florida. They get their knees repaired, tonsils removed and even undergo mastectomies — all without having to spend a night in the hospital.

Outpatient surgery has increased dramatically over the past few decades, to more than 50 million procedures a year in the United States. There now are more surgeries done on an outpatient basis than those requiring a hospital stay.

The growth is fueled by medical advances, including minimally invasive procedures, better anesthesia and more effective drugs to manage pain at home. Gall bladder surgeries and mastectomies are among procedures that have moved to the outpatient setting in recent years.

Many patients prefer to spend as little time as possible in the hospital. But the growth has also been driven by a need to reduce costs. Procedures at the Morsani Center and freestanding surgical facilities can be done at a fraction of the cost at a hospital, said Jay Wolfson, a health policy expert at USF. Labor, overhead, insurance and maintenance costs are all scaled down considerably at outpatient, also known as ambulatory, centers. Outpatient procedures are also done at hospitals for less cost than inpatient procedures.

In the coming years, more procedures, such as coronary artery stenting or partial knee replacements, are expected to move to the outpatient setting. As of 2006, the most recent year for which data is available, here are the top 10 inpatient surgeries, and the top 10 outpatient procedures; note that some are done in either setting, depending on individual circumstances.

Top 10 outpatient surgeries

Lens and cataract procedures: 7 million

Endoscopy (examination) of large intestine:

5.7 million

Endoscopy of small intestine: 3.4 million

Therapeutic or prophylactic injections and

infusions (of drugs including antibiotics and pain relievers): 1.4 million

Removal of skin lesion or tissue, or subcutaneous tissue: 1.1 million

Arteriography and angiocardiography

(coronary artery examination): 1 million

Knee arthroscopy: 956,000

Hernia repair: 920,000

Tonsillectomy and/or adenoidectomy (removal of tonsils and adenoids): 877,000

Cystoscopy (bladder, urethra examination): 751,000

53 million

Total U.S. outpatient procedures

Top 10 inpatient surgeries

Arteriography and angiocardiography:

1.7 million

Caesarean section: 1.3 million

Cardiac catheterizations: 1.1 million

Endoscopy of small intestine: 1 million

Diagnostic ultrasound: 888,000

Computerized axial tomography (CAT scans): 740,000

Repair or realignment of a broken bone: 672,000

Balloon angioplasty of coronary artery:

661,000

Insertion of coronary artery stent: 652,000

Hysterectomy: 569,000

46 million

Total U.S. inpatient procedures

Source: U.S. Department of Health and Human Services

U.S. outpatient surgery passes inpatient, to 53 million a year 09/26/10 [Last modified: Sunday, September 26, 2010 10:42pm]

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