All stakeholders, whether [[hospital]], [[payer]], or [[patient]]s are now focusing on [[cost]] containment, [[quality]] improvement, and reducing [[length of stay]] for surgical patients. The natural extension of this is a shift in care from the [[inpatient]] setting to [[outpatient]] and [[ambulatory surgery center]]s (ASCs). Due to advances in both [[surgery]] and [[anesthesiology]], many [[operation]]s are now possible in the outpatient setting. For [[spine surgery]] alone, annual cost savings of $140 million have been reported with the use of ASCs
((Silvers HR, Lewis PJ, Suddaby LS, Asch HL, Clabeaux DE, Blumenson LE. Day
surgery for cervical microdiscectomy: is it safe and effective? J Spinal Disord. 
1996 Aug;9(4):287-93. PubMed PMID: 8877954.
)).