Factors influencing patient disposition after ambulatory herniorrhaphy

Purpose: To determine factors associated with patient disposition status other than discharge to their customary residence (DCR) after elective, ambulatory inguinal hernia repair (IHR). Materials and methods: N= 7953 patients who underwent IHR were identified in the National Survey of Ambulatory Surgery (NSAS). Disposition status was examined by age, sex, race, type of anesthetic, anesthesia provider, expected source of payment, laterality of the procedure, facility type and US region. Logistic regression was used to examine independent risk factors for such disposition status. Results: Independent risk factors for disposition status other than DCR included anesthesia type, anesthesia provider, increasing age of the patient, and biversus unilaterality of the procedure. Differences in disposition status were also found by facility type and US region in which the procedure was performed. Discussion: The increased cost associated with a disposition status other than DCR requires identification of factors that independently contribute to such an outcome. In this study a number of anesthesia related and unrelated factors were identified that may impact on the disposition of patients undergoing ambulatory inguinal hernia repair. In light of limitations inherent to analysis of large databases our results should be interpreted with caution and prospective trials are needed for validation of our findings. The value of our results may lie particularly in the hypothesis generation for such trials. © 2005 Elsevier B.V. All rights reserved.