Outpatient surgery performed in an ambulatory surgery center versus a hospital: comparison of perioperative time intervals

Trentman, Terrence L.; Mueller, Jeff T.; Gray, Richard; Pockaj, Barbara A.; Simula, Daniel V.

doi:10.1016/j.amjsurg.2009.06.029

Cited by 31 publications

(25 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most of the reduction in time was during the preoperative phase, which differed from our results that indicated freestanding ASCs were shorter in actual surgery time, time in the operating room, and in postoperative time; data were not available on preoperation surgical time in the NSAS. Trent-man et al 6 did find that freestanding ASC patients spent less time in the postanesthesia care unit than hospital patients (112 vs 121 min; P = .16), which was not as substantial a difference as the time spent in postoperative care that our study found (74 vs 48 min; P <.01).…”

Section: Commentscontrasting

confidence: 65%

“…Our results corroborate the notion that freestanding ASCs tend to be more efficient than hospital-based surgery centers. Trentman et al 6 examined breast surgeries in a freestanding ASC and in the hospital setting and reported that in their freestanding ASC the total time in the facility was 69 minutes shorter than when the same procedures were performed in a hospital setting, although surgeries in the hospital consisted of both inpatient and outpatient surgeries. Most of the reduction in time was during the preoperative phase, which differed from our results that indicated freestanding ASCs were shorter in actual surgery time, time in the operating room, and in postoperative time; data were not available on preoperation surgical time in the NSAS.…”

Section: Commentsmentioning

confidence: 99%

“…Freestanding ASCs were more likely to use IV sedation and monitored anesthesia care for upper-gastrointestinal biopsy, and were more likely to use IV sedation overall. The Trent-man et al 6 study found that use of anesthesia was similar in the freestanding ASCs and the hospital, although they reported that during surgery higher doses of fentanyl and ketorolac were used. The differences in anesthesia use in freestanding ASCs partially may explain the shorter time spent in postoperative care found in our study because there was a shorter recovery time associated with the use of moderate sedation than with the use of general anesthesia.…”

Section: Commentsmentioning

confidence: 99%

“…6–9 However, no studies have compared surgical times for a comprehensive set of ambulatory procedures performed in both hospitals and freestanding ASCs. The objective of this study was to compare surgical times for ambulatory procedures commonly performed in both hospitals and freestanding ASCs.…”

mentioning

confidence: 99%

See 3 more Smart Citations

A comparison of ambulatory perioperative times in hospitals and freestanding centers

Hair

Hussey

Wynn

2012

The American Journal of Surgery

View full text Add to dashboard Cite

BACKGROUND The volume of surgical procedures performed in ambulatory surgical centers has increased rapidly. METHODS Ambulatory surgical visits of Medicare beneficiaries were compared for hospital-based and freestanding ambulatory surgical centers (ASCs). The main outcomes were time in surgery, time in operating room, time in postoperative care, and total perioperative time. RESULTS The mean total perioperative time for all procedures examined was 39% shorter in freestanding ASCs then in hospital-based ASCs (83 vs 135 min; P <.01); surgery time was 37% shorter (19 vs 30 min; P < .01), operating room time was 37% shorter (34 vs 54 min; P < .01), and postoperative time was 35% shorter (48 vs 74 min; P< .01). CONCLUSIONS Perioperative times were significantly shorter in freestanding ASCs than in hospital-based ASCs. It is unclear how much of the difference was the result of efficiency versus patient selection.

show abstract

Section: Commentscontrasting

confidence: 65%

Section: Commentsmentioning

confidence: 99%

Section: Commentsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

A comparison of ambulatory perioperative times in hospitals and freestanding centers

Hair

Hussey

Wynn

2012

The American Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…By analogy with the studies of the ambulatory care-sensitive conditions that have led to a radical reduction of the medical admissions to hospitals, a few studies that are likely to promote a partial surgical de-hospitalization should be implemented [21]. In fact, in the surgical field, the comparison between ASC and hospital-based facility is still an open question, besides being quite a controversial point [22-24]. …”

Section: Discussionmentioning

confidence: 99%

De-hospitalization of the pediatric day surgery by means of a freestanding surgery center: pilot study in the lazio region

et al. 2012

View full text Add to dashboard Cite

BackgroundDay surgery should take place in appropriate organizational settings. In the presence of high volumes, the organizational models of the Lazio Region are represented by either Day Surgery Units within continuous-cycle hospitals or day-cycle Day Surgery Centers. This pilot study presents the regional volumes provided in 2010 and the additional volumes that could be provided based on the best performance criterion with a view to suggesting the setting up of a regional Freestanding Center of Pediatric Day Surgery.MethodsThis is an observational retrospective study. The activity volumes have been assessed by means of a DRG (Diagnosis Related Group)-specific indicator that measures the ratio of outpatients to the total number of treated patients (freestanding indicator, FI). The included DRGs had an FI exceeding the 3rd quartile present in at least a health-care facility and a volume exceeding 0.5% of the total patients of the pediatric surgery and urology facilities of the Lazio Region. The relevant data have been provided by the Public Health Agency and relate to 2010. The best performance FI has been used to calculate the theoretical volume of transferability of the remaining facilities into freestanding surgery centers. Patients under six months of age and DRGs common to other disciplines have been excluded. The Chi Square test has been used to compare the FI of the health-care facilities and the FI of the places of origin of the patients.ResultsThe DRG provided in 2010 amounted to a total of 5768 belonging to 121 types of procedures. The application of the criteria of inclusion have led to the selection of seven final DRG categories of minor surgery amounting to 3522 cases. Out of this total number, there were 2828 outpatients and 694 inpatients. The recourse of the best performance determines a potential transfer of 497 cases. The total outpatient volume is 57%. The Chi Square test has pointed to a statistically significant difference of the facilities and to a non-significant difference of inferiority of the regional places of origin with respect to the city of Rome.ConclusionsThe activity volumes would seem to support the setting up of a Freestanding Regional Center of Pediatric Day Surgery. This Center represents the healthcare facility that is most likely to allow a de-hospitalization process. Subsequent studies will be required to confirm the validity of this pilot study.

show abstract

Association of Race, Health Insurance Status, and Household Income With Location and Outcomes of Ambulatory Surgery Among Adult Patients in 2 US States

et al. 2020

View full text Add to dashboard Cite

The receipt of surgery in freestanding ambulatory surgery centers (ASCs) is often less costly compared with surgery in hospital-based outpatient departments. Although increasing numbers of surgical procedures are now being performed in freestanding ASCs, questions remain regarding the existence of disparities among patients receiving care at ASCs. OBJECTIVE To examine the association of patient race, health insurance status, and household income with the location (ASC vs hospital-based outpatient department) of ambulatory surgery. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the State Ambulatory Surgery and Services Databases of the Healthcare Cost and Utilization Project to perform a secondary analysis of patients who received ambulatory surgery in New York and Florida between 2011 and 2013. Patients aged 18 to 89 years who underwent 12 different types of ambulatory surgical procedures were included. Data were analyzed from December 2018 to June 2019. MAIN OUTCOMES AND MEASURESReceipt of surgery at a freestanding ASC and 30-day unplanned hospital visits after ambulatory surgery. RESULTS A total of 5.6 million patients in New York (57.4% female; 68.9% aged Ն50 years; and 62.5% White) and 7.5 million patients in Florida (57.3% female; 77.4% aged Ն50 years; 74.3% White) who received ambulatory surgery were included in the analysis. After adjusting for age, comorbidities, health insurance status, household income, location of surgery, and type of surgical procedure, the likelihood of receiving ambulatory surgery at a freestanding ASC was significantly lower among Black patients (adjusted odds ratio [aOR], 0.82; 95% CI, 0.81-0.83; P < .001) and Hispanic patients (aOR, 0.78; 95% CI, 0.77-0.79; P < .001) compared with White patients in New York. This likelihood was also lower among Black patients (aOR, 0.65; 95% CI, 0.65-0.66; P < .001) compared with White patients in Florida. Public health insurance coverage was associated with a significantly lower likelihood of receiving ambulatory surgery at freestanding ASCs in both New York and Florida, particularly among patients with Medicaid

show abstract

Outpatient surgery performed in an ambulatory surgery center versus a hospital: comparison of perioperative time intervals

Cited by 31 publications

References 22 publications

A comparison of ambulatory perioperative times in hospitals and freestanding centers

A comparison of ambulatory perioperative times in hospitals and freestanding centers

De-hospitalization of the pediatric day surgery by means of a freestanding surgery center: pilot study in the lazio region

Association of Race, Health Insurance Status, and Household Income With Location and Outcomes of Ambulatory Surgery Among Adult Patients in 2 US States

Contact Info

Product

Resources

About