A community-based analysis of ambulatory surgery utilization.

We conducted a study to determine the utilization level for ambulatory surgery and the proportions of specific procedures which could be performed in certain ambulatory settings in one community, Syracuse, New York, which has used this service extensively. It was estimated that, in 1983, 26.9 surgery cases per 1,000 population in Syracuse were performed in ambulatory settings. This level amounted to approximately 37 per cent of hospital-based surgery in the area. Analysis of surgery utilization in two hospital-integrated and freestanding ambulatory surgery facilities indicated that more than 95 per cent of myringotomies, tonsillectomies, and adenoidectomies as well as substantial proportions of carpal tunnel releases, lens extractions, sterilizations, circumcisions, and inguinal hernia repairs in these two facilities were performed in ambulatory settings. The availability of dedicated facilities and full-time staff produced higher utilization for these procedures in freestanding facilities. The utilization levels for individual procedures identified in the study can be employed in the planning of hospital-integrated and freestanding programs.