Hospital admission following ambulatory surgery

BACKGROUND: Ambulatory surgery continues to grow in quantity and complexity of procedures. Effective measures of ''quality'' are not readily apparent. ''Unplanned admission rate'' may well reflect the quality of care in this area. Identifying factors related to this event could be helpful in quality assessment and improvement. METHODS: A review of all unplanned admissions for a 3-year period in a University-affiliate teaching hospital. RESULTS: An overall rate of 0.85% (129/15,132) was observed. Rate varies by specialty and no one procedure was at higher risk. Pain control, cardiopulmonary, and bleeding problems as well as larger than anticipated procedures accounted for 73% of the admissions. CONCLUSIONS: Unplanned admission following ambulatory surgery is relatively rare but could reflect overall quality in terms of the system, physician, and patient. Comparisons between institutions and within institution requires defining key demographic elements whose identification for now remains a challenge.