Technology and reimbursement patterns have increased the amount of surgery performed on an ambulatory basis. Hospitals all over the country are experiencing a rise in the number of surgical patients who come into the hospital and go home on the same day; cases that previously required at least an overnight stay in the hospital. The move to outpatient treatment can significantly affect a hospital’s use of beds and its overall organization. However, the move to outpatient care also poses some risks, especially to patients with difficult medical histories. The move from inpatient to outpatient care is driven by cost containment, as well as by new technologies. However, there are risks to care provided in the ambulatory setting. For example, advanced age (especially older than 70 years) is associated with increased hospital stay and perioperative morbidity and mortality. Additionally, the type of surgery is important in the risk assessment.
In the following three case scenarios, determine if the patient has an increased risk for surgical complications based on their current health status and medical history. Write a 1-2 paragraph response for each scenario, and determine the following:
- Does the patient’s medical history pose a potential risk for complications prior/post surgery? Explain your reasoning.
- Based on the patient’s current health status and their medical history, should they receive surgery or be evaluated and treated outside of the ambulatory care setting? Explain your reasoning.
Case Scenario 1:
Case Scenario 2:
Case Scenario 3: