Rapid hospital discharge following laparoscopy for ectopic pregnancy. A promise unfulfilled?

This study was done to determine whether laparoscopy for ectopic pregnancy in the United States is associated with rapid postoperative discharge, defined as 2 days or less, and to estimate how often ambulatory treatment of ectopic pregnancy occurs without subsequent hospital admission. We used the National Hospital Discharge Survey to estimate the frequency of ectopic pregnancy admissions, operations, and length of hospital stays in 1990. We used the National Ambulatory Medical Care Survey to estimate the number, type, and disposition of office visits for ectopic pregnancy in 1990. According to National Hospital Discharge Survey data, tubal pregnancy led to an estimated 57,000 hospital admissions in 1990. Most (70%) of the 26,000 patients treated with laparoscopy were in the hospital 3 days or more, and most (73%) underwent salpingectomy. The number of ambulatory visits for ectopic pregnancy was too low to estimate reliably according to the standards of the National Center for Health Statistics. We found that laparoscopy was used frequently for the treatment of ectopic pregnancy but was not associated with rapid postoperative discharge. Further research is needed to determine whether these findings persist and whether reimbursement incentives, patient preference, or problems with the diffusion of technology are responsible.