Regional and Intrametropolitan Differences in the Location of Freestanding Ambulatory Surgery Centers∗

Abstract

The freestanding ambulatory surgery center (FASC), also known as an outpatient or day surgery center, is one of several modern health care providers which are currently challenging the dominance of traditional medical professionals. This paper examines the location and distribution of FASCs in the United States for the period 1987–1992. FASCs tend to be concentrated in the states of the South and West, and have exhibited increasing concentration in these regions during the five‐year study period. In addition, FASCs are found mostly in metropolitan areas and appear to be moving toward more suburban locations, although central city sites still dominate. Future research should concentrate on more micro‐scale locations of the FASC and other nontraditional health care providers.

Are Hospitals an Export Industry?

“…In 2005, hospitals accounted for a slightly smaller share of industry jobs than did ambulatory health care. The trend in staffing patterns away from hospitals reflects the increased demand for nursing and residential care facilities as a result of the aging of the population and the continued expansion of outpatient surgery centers driven by improvements in medical technology, government policy, and increasing competition and price sensitivity in health care markets (Adams, 2003;Hiles, 1992;Lowell-Smith, 1993). Despite the relatively slow growth of hospitals, the expansion of overall hospital employment that began in the mid-1980s has persisted (Wootton & Ross, 1995) and is likely to continue regardless of economic conditions.…”

Urgent Care Center Location: an Empirical Analysis of their Locations in Relation to Demographic, Socioeconomic, and Land Use Factors: a Case Study of Portland, Oregon

“…Other authors suggest that a major reason for the shift to UCCs is the advent of technological advances using new laser applications, and computerized surgical instruments and diagnostics. These advances have reduced the need for lengthy in-patient stays and recovery times and encouraged the move to outpatient UCCs (MacDowell and Perry, 1990;Lowell-Smith, 1993). Miller and Sulvetta (1992, p. 135) suggest that technological advances are the most important force behind the shift to treatment in out-patient settings, while PPS has only "added momentum to this process."…”

“…UCCs remain open 24 hours a day and offer urgent care with no appointment required (Daft and Bush, 1990;Lumpkin and Tudor, 1990). UCCs are challenging traditional medical care with an adaptation of modern business practices to the health care delivery system (Piested, 1991;Lowell-Smith, 1993 ). "Health service rendered to patients not confined to a bed is the most common mode of delivery of health services in the United States today" (Burns, 1991 ).…”

“…In contrast with the considerable amount of research available on traditional HCFs, little has been published about the characteristics of existing UCC locations. According to Lowell-Smith (1993), "Most studies of F ASC have concentrated on utilization and competition factors rather than their location and geographic distribution." Recently, there has been greater interest in understanding the selection and distribution of UCCs in cities (Kovner, 1990;Kassaye and Tseng, 1990;Lancaster and Boissoneau, 1990;Nauert, 4 1992;Heischmidt et al, 1993 ).…”