Understanding the Difference Between Inpatient and Outpatient Surgery

By Travis J. Hamilton, DO, MMHC, FASA

If you are preparing for surgery, you’ve likely heard the terms “inpatient” and & “outpatient”. These designations
refer to whether a procedure requires an overnight hospital stay, known as inpatient, or allows you to go home
the same day, known as outpatient. Understanding the differences between these approaches can help you make
informed decisions about your care.

Inpatient surgery typically involves more complex procedures that require close monitoring during recovery.

Patients who undergo inpatient surgeries often stay in a hospital overnight or several days, so that a provider can
manage pain, address any complications that arise, and monitor progress. Examples of common inpatient
surgeries include major joint replacements for the hips or knees, organ transplants, heart surgeries, or certain
cancer-related procedures. While inpatient surgery is necessary and beneficial for certain health concerns, it also
involves a longer recovery period and higher costs as a result of extended hospital stays.
With advancements in technology and surgical techniques, many procedures that once required an overnight or longer-term hospital stay are now able to be done safely without admission to a hospital. At ambulatory care centers, or outpatient facilities, providers can perform minimally invasive surgeries that are streamlined, allowing patients to arrive, undergo prep and surgery at the facility, and recover in the comfort of their own
home, all in the same day. This minimizes disruptions to daily life without the additional expense of a hospital stay and allows patients to return to regular activities more quickly.

Common outpatient procedures include joint repairs, gallbladder removal, cataract surgery and hernia repairs.

In addition to these advancements, newer anesthesia methods are making surgeries easier for patients. For example, pain blockers can target specific areas of the body to reduce pain during and after surgery. This means patients often need fewer pain medications and can recover faster.

Enhanced Recovery After Surgery (ERAS) programs are also helping patients heal better. These programs use simple steps like managing pain with less medication, encouraging patients to move around sooner, and providing meals that support healing to help
patients bounce back more quickly and with fewer problems. These methods are primarily used for patients recovering from major inpatient surgeries to assist with recovery.

Newer services such as a Virtual Preoperative Evaluation Clinic (VPEC) can make surgery even safer and easier for patients. Using telehealth, VPEC allows patients to meet with their healthcare team online before surgery.

This helps make sure they are as healthy as possible going into a surgical procedure, which lowers the chances of problems and helps patients recover better.

When deciding whether a procedure should be performed on an inpatient or outpatient basis, doctors consider several factors including the complexity of the procedure, the patient’s overall health, and the availability of a support system. Complex surgeries that carry higher risks or require general anesthesia typically require inpatient care to ensure ongoing monitoring and allow for a quicker intervention time if needed. Considering a
patient’s medical history and overall health is also critical in determining which approach is right for you.

Conditions such as diabetes, heart disease or a compromised immune system may require additional resources that would only be available in an inpatient setting, while generally healthy patients can safely recover at home after an outpatient surgery.

Lastly, outpatient surgeries require a reliable support system. Patients will need someone to drive them home, help with medication management, and assist with daily tasks as they recover because outpatient surgery can still impact the ability to walk or perform basic activities. If sufficient support is not available, inpatient care may be the safer choice.

Your healthcare provider will recommend the best approach for your surgery based on your specific needs. It is still essential to ask questions, understand why a particular approach is recommended, and ensure you have weighed the pros and cons of every option available to you. Consider factors such as the expected recovery time, risks involved, and the availability of support at home to make the best decision for your health.

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