The Impact of Relocating Vasectomies from Hospital Outpatient Departments to Non-hospital Sites

Abstract

The objective of this study was to estimate the net dollar value of hospital resources that would be released if vasectomies currently performed in outpatient departments were performed in non-hospital sites. This article provides a descriptive analysis using administrative data for all non-hospital sites and all acute care institutions in Ontario performing vasectomies. It is based on 23,741 records of patients for whom a vasectomy was billed to the Ontario Health Insurance Plan (OHIP) in 1991-92. No substantial differences in the age distribution of patients were seen in non-hospital sites and those in hospital settings. About 75% of hospital outpatients received a local anesthetic that could have been administered in a non-hospital setting. Approximately $4.4 million in hospital resources would be released if 75% of all outpatient vasectomies were performed in non-hospital settings while OHIP billings would increase only by about $140,000. The demands on hospital funds available for patient activity could have been decreased by about $6.2 million, if this shift had occurred in 1991-92. Although opportunities exist in Ontario to release hospital resources by shifting vasectomies to non-hospital sites, current hospital and physician funding policies may represent a disincentive to shift activity away from institutional-based care.