Ambulatory Surgery Centers and Outpatient Procedure Use Among Medicare Beneficiaries

Bibliographic Data

ID9102253
AuthorsBrent K Hollenbeck (0000-0003-4840-1260, corresponding author), Rodney L Dunn (0000-0002-4148-8538), Anne M Suskind (0000-0002-8437-3861), Yun Zhang (0000-0002-0960-7445), John M Hollingsworth (0000-0002-3372-9370, corresponding author), John D Birkmeyer (University of Michigan, corresponding author)
Year2014
Volume52
Issue10
Pages926-931
Publication date2014-10-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000213
PMID25185636
PMCIDPMC4163137
OpenAlexW2020613158
LanguageEN
Citations received2
References cited13

BACKGROUND: There has been a strong push to move outpatient surgery from hospital settings to ambulatory surgery centers (ASCs). Despite the efficiency advantages of ASCs, many are concerned that these facilities could increase overall utilization. OBJECTIVE: To assess the impact of ASC opening on rates of outpatient surgery. DESIGN: This was a retrospective cohort study of Medicare beneficiaries undergoing outpatient surgery between 2001 and 2010. We compared population-based rates of outpatient surgery in Hospital Service Areas (HSAs) with freestanding ASCs to those without. After adjusting for differences using multiple propensity score methods, we assessed the impact of ASC opening in an HSA previously without one on rates of outpatient surgery. SUBJECTS: Patients included were Medicare beneficiaries with Part B eligibility. MAIN OUTCOME MEASURE: Adjusted HSA-level rates of outpatient surgery. RESULTS: Adjusted outpatient surgery rates increased from 2806 to 3940 per 10,000 and the number of ASC operating rooms grew from 7036 to 11,223 (both P<0.001 for trend). By the fourth year after opening, rates of outpatient surgery increased by 10.9% (from 3338 to 3701 per 10,000) in HSAs adding an ASC for the first time. In contrast, outpatient surgery rates grew by only 2.4% and 0.6% in HSAs where an ASC was always or never present, respectively (P<0.001 for test between 3 slopes). CONCLUSIONS: Rather than redistributing patients from one setting to another, the opening of ASCs increases outpatient surgery use. However, the 10.9% increase is more modest than previously suggested by state-level data

Ambulatory · Ambulatory care · Cohort · Health care · Outpatient surgery · Outpatient visits · Population · Retrospective cohort study · Emergency Medicine · Healthcare Operations and Scheduling Optimization · Healthcare Policy and Management · Internal Medicine · Medicine · Nausea and vomiting management · Surgery

Tools

Open DOISci-HubOpen Access