Should You Have Inpatient or Outpatient Surgery?

The Pros and Cons of Recovering at Home or in the Hospital

Will Your Surgery Be Inpatient or Outpatient?.

If you are having surgery, you may be given the option of having your procedure as an inpatient or an outpatient.  

Most procedures are done strictly as one or the other.  A minor procedure, such as a carpal tunnel release, is done as an outpatient procedure unless there is an unexpected complication.  Conversely, major surgery, such as an open heart surgery, is always strictly done as an inpatient procedure because of the monitoring and recovery needs of the typical patient.


There are some procedures that fall into a grey area, allowing the patient to choose whether they would like to be hospitalized overnight for the first night of their recovery, or recover at home once the procedure is over and the anesthesia has worn off.  

What Happens as an Inpatient

Ideally, once surgery is complete a medication is given to reverse the effects of anesthesia and allow the patient to wake.  The patient is taken to the recovery area, often called the Post Anesthesia Care Unit or PACU, where they are closely monitored until they are awake and alert.  The patient is then taken to their hospital room where they can rest, with the nursing staff providing care overnight.  Barring any unforeseen complications, if the patient is able to walk, urinate and pass gas the patient is typically discharged the next morning or early afternoon.  

What Happens as an Outpatient

Outpatient surgery may be performed in a hospital, or in a surgery center that is freestanding, meaning it is not inside a hospital facility.


Once the surgery is complete, medication is given to reverse the effects of anesthesia.  The patient is then taken to the recovery area to slowly wake up while being closely monitored for any potential complications.  Once the patient is awake, able to pass gas, urinate and walk, if they show no signs of complications they are typically allowed to return home to continue their recovery.

Here are some things that you should consider prior to making that decision:


The cost to you may be very different if you elect an inpatient recovery versus an outpatient recovery, especially if you are paying out of pocket for your surgery.  An elective surgery that insurance does not pay for may be much more expensive with an inpatient recovery.  If insurance is paying the bill, an inpatient recovery may be fully covered, may have a higher deductible, or may have no increase in the fees passed on to you.  The difference can be significant with some insurance carries, such as Medicare. 

To determine the difference in cost, you will need to speak with your surgeon and your insurance company if you will be utilizing your insurance coverage.  Keep in mind there are additional important factors to consider beyond cost, but cost is typically the primary reason patients elect to recover at home.

Where Do You Recover as an Inpatient?

If you are having surgery at a hospital, an inpatient recovery will happen on a unit in that facility.

  If you are having surgery as an outpatient, the answer will depend upon that facility and their ability to offer inpatient services.  Some freestanding facilities do offer an inpatient recovery, others have arrangements with nearby hospitals to admit patients who have a complication and require an unexpected overnight stay.  

Your surgeon, or the surgical center that they utilize, will be able to explain what type of inpatient services are offered and where.  Your surgical center may also be able to offer private duty nursing services, where you would recover in your home with a nurse present overnight or stopping by on a schedule to provide care.

What is Going on at Home?

Only you know if your home is an appropriate place to recover from surgery.  Will your home be quiet and restful the day of your surgery? How about the day after surgery? Will your child’s soccer team be having a sleepover upstairs or is your neighbor planning an enormous party that is going to be loud late into the night?  Will your spouse be doing a remodeling project in your kitchen that keeps you awake all day? If your house isn’t appropriate, can you go to a friend’s home and rest quietly?

Are You Capable of Recovering Quietly at Home?

Perhaps a more important question than is your home a good place to recover is this: are you capable of recovering at home?  Will you rest and take care of yourself, or will you be checking your email and returning work phone calls instead?  Will you be trying to tame your toddler while doing laundry, making dinner and cleaning the house?  If you know you are not capable of ignoring housework for a few days, perhaps you should consider an inpatient recovery day or recovering at someone else’s house where you won’t feel the temptation to do those tasks in the day following surgery.

Pain Management

Are confident that your surgical pain can be managed at home? Surgeons prescribe pain medication that is intended to appropriately treat your pain; however, if you already have pain that can be challenging to manage, you may want to discuss your pain control needs with your surgeon prior to surgery.  If you determine, together, that your pain may be a challenge, you may want to consider an inpatient recovery day.

Improving Your Pain Management After Surgery

Your Medical History

Your medical history may play a role in your ability to safely recover at home.  If you have serious medical conditions such as diabetes, a serious heart condition or another complicated issue, it may be safer to be more closely monitored in the day following surgery.  Discuss your medical history with your surgeon to determine if you are a good candidate for outpatient surgery.

Available Assistance

Will someone be available to help you? You won’t be permitted to drive yourself home after surgery, so a friend who is willing to be your driver for a day is an absolute necessity.  Depending on the nature of your surgery, you may be able to drive the next day, or it may be weeks before you are behind the wheel.  

Even minor surgery can make simple tasks a major pain.  What is described as a minor hand surgery can make everyday tasks like getting dressed and brushing your teeth much more difficult.  Your normal routine will certainly be impacted, if only for a few days.

Inpatient Versus Outpatient For Insurance

For the purposes of this article, inpatient recovery means staying in the hospital overnight to recover from surgery while outpatient means leaving the hospital after surgery to recover at home.  

Insurance companies use these definitions in a different way, inpatient is defined as a hospital stay that lasts two or more nights, outpatient means a hospital stay that lasts less than one night.  For more information on how insurance companies use the terms inpatient and outpatient, read Observation Versus Inpatient Hospital Stays.  

Before You Decide

It is very important to remember that there can be dramatic differences in the costs associated with surgery based on the amount of time spent in the hospital, determining the costs associated with each type of stay prior to your procedure can potentially save thousands of dollars in copays and deductibles.


Find out if you are an inpatient or an outpatient--it affects what you pay. Accessed March, 2015.

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