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Feasibility and economic impact of same-day discharge for women who undergo laparoscopic hysterectomy

Authors
Journal
American Journal of Obstetrics and Gynecology
0002-9378
Publisher
Elsevier
Volume
207
Issue
5
Identifiers
DOI: 10.1016/j.ajog.2012.09.014
Keywords
  • Discharge
  • Hysterectomy
  • Laparoscopic Hysterectomy
  • Laparoscopically Assisted Vaginal Hysterectomy
  • Laparoscopy
Disciplines
  • Economics
  • Medicine

Abstract

Objective We examined the use, safety, and economic impact of same-day discharge for women undergoing laparoscopic hysterectomy. Study Design We identified women in the Perspective database who underwent laparoscopic hysterectomy from 2000 through 2010. Discharge was classified as same-day, 1 day, and ≥2 days. Multivariable models were used to examine predictors of same-day discharge, reevaluation, and cost. Results Among 128,634 women, 34,070 (26.5%) were discharged on the day of surgery. Same-day discharge increased from 11.3% in 2000 to 46.0% by 2010 (P < .0001). The rate of reevaluation within 60 days was 4.0% for those discharged same day, 3.6% after a 1-day stay, and 5.1% for patients whose stay was ≥2 days (P < .0001). In a multivariable model, patients discharged on postoperative day 1 were less likely to require reevaluation (risk ratio, 0.89; 95% confidence interval, 0.82–0.96), but costs were $207 (95% confidence interval, $179–234) greater. Conclusion Same-day discharge after laparoscopic hysterectomy is safe and associated with decreased cost.

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