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Ambulatory surgery: definition, history

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Ambulatory surgery of the lower limb: ligamentoplasty
Ambulatory surgery appears from the early twentieth century. It's in the 70s it began to grow in the US, to grow rapidly in the 80s.
DEFINITION ambulatory surgery:
According to the International Association for Ambulatory Surgery, the "day surgery" or "outpatient surgery", are:
"The surgery scheduled and performed under technical conditions requiring operating room, anesthesia variable mode and postoperative monitoring in the recovery room for without increased risk, patient out on the day of admission. "
The total duration of its management does not require an overnight stay in the hospital.
DEVELOPMENT abroad and in France
The development of ambulatory surgery in France has fallen behind compared to other countries of the world and Europe. Comparing the practice of ambulatory surgery in the United States, Canada and the UK has shown some differences. These are financial constraints that motivated primarily the development of ambulatory surgery in the United States and Canada. In the US, financial incentives have been implemented by public and private payers. In 1970, 35% of the paying agencies were paying the procedures performed in ambulatory surgery; this rate was 96% in 1980. Some payers, particularly Medicare, only 80% were paying surgeons fees if surgery was traditionally performed in 1982 ... In 1993, arthroscopy was the first of twenty major ambulatory surgery procedures performed in independent centers of the United States.
In Canada, health expenditures financing problems have motivated favoring bed closures development of ambulatory surgery.
In the UK, the development of ambulatory surgery was mainly initiated by the will of the government to reduce surgical wait lists. In 1985, ambulatory surgery was officially approved by the Royal College of Surgeons of England which estimated that nearly 50% of surgical procedures could be performed as an outpatient. It established recommendations is a guide, since, regularly reassessed.
Ambulatory surgery in France:
In France, before 1991, ambulatory surgery was developing outside any legal framework and there were no statistical data to assess the role of this support. The law of 31 July 1991 has created alternative care facilities to hospitalization. In 1980, only 5% of surgical procedures were performed in outpatient and 27% in 1997.
Today about 40% of patients operated on in France were supported in ambulatory surgery.
An investigation by Medicare, in February 2007, indicates that a large majority of French (80%) would be prepared to use ambulatory surgery.


Doctor Yoann BOHU, Doctor Nicolas LEFEVRE, Doctor Serge HERMAN. - 4 novembre 2013.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.


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