You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-Based Medicine & Outcomes (I)1 Apr 201362 ASSESSING THE INTENDED EFFECTS OF AMBULATORY SURGERY CENTERS ON THE DELIVERY OF OUTPATIENT UROLOGIC PROCEDURES Anne M. Suskind, Rodney L. Dunn, Zhang Yun, John M. Hollingsworth, Bruce L. Jacobs, Florian R. Schroeck, and Brent K. Hollenbeck Anne M. SuskindAnne M. Suskind Ann Arbor, MI More articles by this author , Rodney L. DunnRodney L. Dunn Ann Arbor, MI More articles by this author , Zhang YunZhang Yun Ann Arbor, MI More articles by this author , John M. HollingsworthJohn M. Hollingsworth Ann Arbor, MI More articles by this author , Bruce L. JacobsBruce L. Jacobs Ann Arbor, MI More articles by this author , Florian R. SchroeckFlorian R. Schroeck Ann Arbor, MI More articles by this author , and Brent K. HollenbeckBrent K. Hollenbeck Ann Arbor, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1438AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Delivery settings for outpatient procedures have evolved over the past two decades to include various non-hospital based facilities, including ambulatory surgery centers (ASCs). The purpose of these facilities was to redistribute appropriate patients from the more expensive hospital setting without compromising quality. The objective of this study was to assess the impact of ASCs opening on rates of procedures performed in hospital-based outpatient facilities and on adverse events following these procedures. METHODS This is a retrospective cohort study of Medicare beneficiaries undergoing ambulatory surgery between 2001 and 2009 at either hospital or freestanding ASCs. Ophthalmologic, gastrointestinal, musculoskeletal, and urologic procedures were evaluated. Difference-in-difference methods were used to estimate the effects of ASCs opening on outcomes at the level of the Hospital Service Area (HSA), including population-based rates of hospital-based outpatient surgery, mortality, and hospital admission within 30 days of an outpatient procedure. RESULTS The number of freestanding ASCs in the US increased from 3,378 in 2001 to 4,573 in 2009. Rates of utilization of hospital-based outpatient surgery (overall) and outpatient urological surgery according to ASC capacity are shown in the figure. Markets where ASCs were added showed large declines in rates of hospital-based urologic outpatient surgery, from 59.2 urologic procedures per HSA at baseline, to 45.5 and 39.1 at 2 and 4 years after ASC opening, respectively. Trends were similar for ophthalmologic, gastrointestinal, and musculoskeletal outpatient procedures. Mortality and hospital admission rates within 30 days of outpatient surgery remained stable for all specialties after ASC openings. CONCLUSIONS The opening of an ASC in a healthcare market resulted in significant declines in corresponding hospital-based surgery without increasing population-based mortality or hospital admission. This suggests that ASCs can successfully offload procedures from the more expensive hospital setting without negatively impacting quality on a population level. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e26 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anne M. Suskind Ann Arbor, MI More articles by this author Rodney L. Dunn Ann Arbor, MI More articles by this author Zhang Yun Ann Arbor, MI More articles by this author John M. Hollingsworth Ann Arbor, MI More articles by this author Bruce L. Jacobs Ann Arbor, MI More articles by this author Florian R. Schroeck Ann Arbor, MI More articles by this author Brent K. Hollenbeck Ann Arbor, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...