[International comparison of ambulatory surgery: status in the United States].

Over the last twenty years, the most dramatic change in American surgical care has been the shift from inpatient to outpatient surgical care. Ambulatory surgery in the 1990s, with its demonstrated ability to lower individual patient and overall societal surgical care costs, while maintaining quality equal to inpatient services, has been embraced by all segments of the American health care delivery system. Accordingly, this fundamental and sometimes little regarded phenomenon now accounts for approximately 50% of all surgical operations performed in the United States. Few health care professionals would dispute the fact that the steady growth of ambulatory surgery has decidedly changed the manner in which American surgeons practice the art and science of surgery. It also appears likely that ever increasing numbers of surgical operations will be completed on an outpatient basis. Ambulatory surgery is one of those rare socioeconomic-political movements in which all participants have benefitted as demonstrated by public interest and demand, surgeon satisfaction, patient participation, and, most importantly, payer encouragement and mandate.