title: Feasibility and economic impact of same-day discharge for women who undergo laparoscopic hysterectomy.
abstract: OBJECTIVE
  We examined the use, safety, and economic impact of same-day discharge for women undergoing laparoscopic hysterectomy.
  
  
  METHODS
  We identified women in the Perspective database who underwent laparoscopic hysterectomy from 2000 through 2010. Discharge was classified as same-day, 1 day, and ≥2 days. Multivariable models were used to examine predictors of same-day discharge, reevaluation, and cost.
  
  
  RESULTS
  Among 128,634 women, 34,070 (26.5%) were discharged on the day of surgery. Same-day discharge increased from 11.3% in 2000 to 46.0% by 2010 (P < .0001). The rate of reevaluation within 60 days was 4.0% for those discharged same day, 3.6% after a 1-day stay, and 5.1% for patients whose stay was ≥2 days (P < .0001). In a multivariable model, patients discharged on postoperative day 1 were less likely to require reevaluation (risk ratio, 0.89; 95% confidence interval, 0.82-0.96), but costs were $207 (95% confidence interval, $179-234) greater.
  
  
  CONCLUSIONS
  Same-day discharge after laparoscopic hysterectomy is safe and associated with decreased cost.
authors.affiliation: Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
authors.forename: Maria B
authors.initials: MB
authors.lastname: Schiavone
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Herzog
authors.forename: Cande V
authors.initials: CV
authors.lastname: Ananth
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Wilde
authors.forename: Sharyn N
authors.initials: SN
authors.lastname: Lewin
authors.forename: William M
authors.initials: WM
authors.lastname: Burke
authors.forename: Yu-Shiang
authors.initials: YS
authors.lastname: Lu
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
authors.forename: Jason D
authors.initials: JD
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000191:economics / Q000379:methods* / Q000639:trends; D010535:Laparoscopy / Q000191:economics / Q000379:methods* / Q000639:trends; D007902:Length of Stay / Q000191:economics / Q000639:trends; D008875:Middle Aged; D010351:Patient Discharge / Q000191:economics* / Q000639:trends; D016896:Treatment Outcome; D055815:Young Adult