Cost-Effectiveness Of Ambulatory Surgery In Cali, Colombia

To compare the cost and effectiveness of a system of simplified ambulatory surgery against traditional inpatient surgery, we studied a surgical procedure commonly performed in both settings - non-recurrent elective inguinal herniorrhaphy. We compared the 17 operations performed in an 'intermediate health unit' (IHU) or outpatient hospital in Cali, against the 15 performed in a traditional secondary hospital from mid-January through mid-April, 1989. Pre-surgical characteristics of the patients were similar. After the operation, the IHU patients had few complications, were more satisfied, and resumed their usual activities sooner than the hospital patients (34 versus 52 days, respectively). The average cost per procedure was US$39.12 in the IHU as compared to US$148.76 in the hospital - a four-fold difference. Intermediate health units seem to offer important advantages for uncomplicated surgery in both cost and outcome.