title: What is the real cost of an overnight stay after an ambulatory general surgical procedure?
abstract: BACKGROUND
  Outpatient surgery is performed widely throughout the Army Medical Command (MEDCOM). It is common practice throughout Medical Command to admit barracks dwelling active duty service members (ADSMs) undergoing ambulatory surgical procedures for overnight observation. We hypothesized that overnight observation of these individuals has not prevented adverse outcomes that would have otherwise occurred if the patient had been discharged to the barracks.
  
  
  METHODS
  We reviewed the postoperative course of all ADSMs undergoing ambulatory surgery with subsequent overnight hospital stay because of primary barracks residence. Procedures included hernia repair, lipoma excisions, and pilonidal cystectomies. Inclusion criteria were ADSMs who stayed overnight purely on the basis of their military barracks residence.
  
  
  RESULTS
  145 patients met our inclusion criteria. Their mean age was 23 ± 3.2, 90.9% were males. The mean hospital length of stay was 24 ± 11.4 hours. There were four (2.78%) postoperative complications, three patients with postoperative urinary retention, and one patient with mild bleeding from a pilonidal excision site, all within 8 hours postoperatively. No adverse outcomes were noted during the period of their hospitalization.
  
  
  CONCLUSIONS
  Barracks dwelling ADSMs do not have adverse outcomes during their inpatient observational hospitalization. An outpatient escort would be sufficient to ensure adequate observation.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431, USA.
authors.forename: Avery
authors.initials: A
authors.lastname: Walker
authors.forename: Doug
authors.initials: D
authors.lastname: Stoddard
authors.forename: George
authors.initials: G
authors.lastname: Black
authors.forename: Marlin
authors.initials: M
authors.lastname: Causey
authors.forename: Robert
authors.initials: R
authors.lastname: Rush
authors.forename: Scott
authors.initials: S
authors.lastname: Steele
authors.forename: Eric
authors.initials: E
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000191:economics*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006772:Hospitals, Military / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000191:economics* / Q000453:epidemiology; D055815:Young Adult