OBJECTIVES: Hysterectomy is one of the most common surgical procedures performed, with about 600,000 surgeries a year. Studies have found that although laparoscopically-assisted vaginal hysterectomies (LAVH) offer patients shorter recovery periods, they are also more resource-intensive. One way to offer patients the improved outcome of LAVH without substantially increasing costs, is to provide it in an outpatient setting. This research project compares resource utilization resulting from the use of LAVH in outpatient versus inpatient settings. METHODS: Patients having a laparoscopically-assisted vaginal hysterectomy performed in Florida hospitals and outpatient surgical centers during 2000 were selected from patient-level data collected by the Florida Agency for Health Care Administration. Patients were excluded from the analysis if they had cancer or if they were under 18 and over 80 years of age. For resource utilization analysis, multiple regression was used to compare non-physician costs across both hospital inpatients and outpatients controlling for patient characteristics. RESULTS: In 2000, there were 3225 laparoscopically-assisted vaginal hysterectomies performed in hospitals and outpatient surgical centers that met our inclusion criteria. Of those surgeries, most (78.4%) were performed in a hospital. Regression results indicate that resource utilization was significantly lower for patients in the outpatient setting, even after controlling for complicating conditions such as prolapse, adhesions and leiomyomas. Charges in the outpatient setting are about $4500 lower than a similar procedure in the hospital. CONCLUSIONS: Although not all hysterectomies are appropriately performed in the outpatient setting, it is clear that resources can be saved by switching settings for uncomplicated cases. Before recommendations can be made, further research is required to assess patients transferred into the hospital after attempting outpatient surgery, and to compare patient satisfaction across the two settings.