The Ambulatory Surgical Center

Abstract

The ambulatory (or outpatient) surgical center is a facility designed to accommodate surgical procedures, usually performed under general anesthesia, that cannot be handled in a physician’s office but do not require overnight hospitalization. Interest in ambulatory surgical centers has grown rapidly in recent years for several reasons: concern about containing rising health-care costs, overcrowding of existing surgical facilities, and advances in both surgery and anesthesia that make possible same-day discharge for patients who in the past would have required hospitalization following surgery. Ambulatory centers reflect the particular needs of the medical community in which they develop. For example, of all surgery performed at Santa Barbara Cottage Hospital’s Outpatient Surgical Center, 15% consists of dilatation and curettages and 15% consists of therapeutic abortions. The surgical demographics of our unit would have been different had there already existed in our community a well-organized gynecologic clinic. The existence of plastic surgery clinics and ophthalmologic clinics will also affect the need for, and constituency of, a general ambulatory surgical unit. Nevertheless, it is clear that such units are a rapidly growing facet of our health-care system,2,9,21 that the quality of care they provide is equal to the care hospital inpatients receive, that they are significantly more convenient to both patient and physician, and that they achieve major cost savings.