Ambulatory surgery: the need for indexes of substitution

Abstract The percentage figures for procedures which can be performed on an ambulatory basis vary in different studies from different institutions. This diversity seems to depend on individual clinicians' preferences for this type of surgery. Management policies for Day Surgery Units require follow-up and evaluation using accurate indexes of substitution. These make it easier to establish tangible objectives, give support to a system of incentives and enable comparisons to be made with other centres. The results of this study show how such an index can be used to monitor the shift in emphasis from inpatient to outpatient care for different surgical procedures and Day Surgery Units.