title: Increasing ambulatory surgery potential by non-medicalized accommodation: matched comparison of the 2011 national hospital activity data to 66 local stays.
abstract: BACKGROUND
  Several policy and cultural factors still hinder the development of ambulatory surgery (AS) in France. Our surgery unit developed a day-surgery approach with extension of a non-medicalized post-operative stay in a hotel-like structure within the hospital, called an "ambulotel". The present study aims to evaluate the potential of this approach in increasing the possibilities of ambulatory surgery by comparing our stays to those of a nationwide database.
  
  
  METHODS
  We matched 66 patients according to seven criteria in our one-day ambulotel program to the 2011 DRG national database and then compared their characteristics.
  
  
  RESULTS
  Of the 10,428 patients in the database with one-night stays in a traditional surgery unit, more than half (52%) would probably have been eligible for ambulatory surgery with a potential theoretical savings estimated at €12,806,568.
  
  
  CONCLUSIONS
  This estimated amount of savings represents a major medical and economic issue. The savings could contribute to increased ambulatory surgery activity in France by creating new dedicated Ambulatory Units, pooling conventional beds, or using night accommodation in non-hospital nursing homes, for example.
authors.affiliation: Unité d'Information Médicale, CHU Cochin, HUPC, AP-HP, 75014 Paris, France. Electronic address: samir.bouam@cch.aphp.fr.
authors.forename: S
authors.initials: S
authors.lastname: Bouam
authors.affiliation: Service de Chirurgie Générale, Plastique et Ambulatoire, CHU Cochin, HUPC, AP-HP, 75014 Paris, France; Faculté de Médecine, Université Paris-Descartes, Sorbonne Paris Cité, 75006 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Gaucher
authors.affiliation: Service de Chirurgie Générale, Plastique et Ambulatoire, CHU Cochin, HUPC, AP-HP, 75014 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Matrella
authors.affiliation: Service de Chirurgie Générale, Plastique et Ambulatoire, CHU Cochin, HUPC, AP-HP, 75014 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Cappiello
authors.affiliation: Unité d'Information Médicale, CHU Cochin, HUPC, AP-HP, 75014 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Frenkiel
authors.affiliation: Service de Chirurgie Générale, Plastique et Ambulatoire, CHU Cochin, HUPC, AP-HP, 75014 Paris, France; Faculté de Médecine, Université Paris-Descartes, Sorbonne Paris Cité, 75006 Paris, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Béthoux
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends*; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D003953:Diagnosis-Related Groups; D005260:Female; D005544:Forecasting; D005602:France; D017048:Health Care Costs; D019538:Health Care Surveys; D006272:Health Facility Environment / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D015994:Incidence; D008297:Male; D009873:Operating Rooms / Q000706:statistics & numerical data; D005791:Patient Care / Q000191:economics / Q000379:methods; D018570:Risk Assessment; D016896:Treatment Outcome
keywords: Day surgery; Diagnostic related groups; Medical care cost-effectiveness; One-day surgery; Patient hotel