Why Are There Differences in the Perceived Safety of Office-Based Surgery?

Abstract

The medical and legislative community should seek to scientifically examine office surgery. Overregulation or loss of office surgery would have a tremendous impact on the management of skin cancers and the delivery of quality cosmetic and laser surgery.

How well does diagnosis-based risk-adjustment work for comparing ambulatory clinical outcomes?

“…Even though mortality related to the ambulatory surgical setting is rare, this indicator has been used to flag potential quality problems associated with ambulatory surgery [6,7,9,25]. Other researchers have also used mortality as an outcome for comparing quality of care provided in the outpatient setting [8,12,26,27]. We used 7-day indicators since, as a shorter measure, it can reduce the effects of extraneous factors unrelated to outpatient procedures [6].…”

Patient safety

“…In short, the data suggest that dermatologic surgery and liposuction under dilute local (tumescent) anesthesia were associated with a very low incidence of adverse events. [6][7][8][9][10][11] Specifically, prospective data from 7 years of mandatory reporting in Florida indicated that dermatologists had not been responsible for a single death. In addition, there were no deaths or hospital transfers associated with liposuction under dilute local anesthesia.…”

“…32 Most individual specialty societies, however, found themselves constrained by insufficient numbers of existing evidence-based guidelines, the high cost of measure development, limited technical expertise as they tried to recruit staff capable of developing measures, and concerns from members who feared the inappropriate use of developed measures by managed care organizations. 10 Those specialty societies with early successes were able to devote significant resources to creating organized infrastructures that engaged membership and simultaneously developed guidelines and linked them to measures with well defined methods for data collection. 10 To assist specialty societies in overcoming barriers and developing physician-level performance measures, the AMA formed the PCPI in 2000.…”

“…10 Those specialty societies with early successes were able to devote significant resources to creating organized infrastructures that engaged membership and simultaneously developed guidelines and linked them to measures with well defined methods for data collection. 10 To assist specialty societies in overcoming barriers and developing physician-level performance measures, the AMA formed the PCPI in 2000. The consortium, comprised of more than 100 state and specialty medical societies, the American Board of Medical Specialties, four federal agencies (including the Agency for Healthcare Research and Quality [AHRQ]), and several other organizations, has developed and approved 261 measures covering 42 clinical areas.…”

Tumescent liposuction: A review

“…It was found that hospital-based liposuction had three times the rate of malpractice settlements when compared with office-based liposuction surgery. [35–37]…”