Key result
Shift toward ambulatory surgery centers linked to a ~12% increase in patient-to-ED distance.
Why the study?
The growth of ambulatory surgery centers as a setting for outpatient procedures raises unique safety concerns due to varying distances from hospital emergency services.
Does the increasing use of ambulatory surgery centers change the accessibility of emergency care for procedural outpatients?
Observational (n=4,300,000)
Yes
Does the increasing use of ambulatory surgery centers change the accessibility of emergency care for procedural outpatients?
Effect estimate: 12.4% increase
The shift of outpatient procedures to ambulatory surgery centers has increased the distance patients must travel to access emergency care, raising potential safety concerns.
Raises caution for complication-prone procedures in distant ASCs; leaves open causal links between accessibility and outcomes in observational data.
The growth of ambulatory surgery centers (ASCs) as a setting for care in the United States raises unique safety concerns. In contrast to hospital-based outpatient departments (HOPDs), ASCs offer care at varying distances from hospital services potentially required to treat complications. To describe changes over time in the accessibility of hospital services for procedural outpatients, this study examined 4.3 million discharges for seven outpatient procedures frequently performed at ASCs and HOPDs. Between 2005 and 2007, the mean patient-to-emergency department (ED) distance increased by 12.4%. This change, which resulted from both an increase in the share of procedures performed at ASCs and an increase in the distance between ASCs and EDs, occurred predominantly within procedures that carried an elevated odds of hospital admission relative to the lowest risk procedures. Further research defining the risks associated with these changes in access to emergency care is needed to inform future ASC policy development and regulation.
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Neuman et al. (2010) conducted an observational in Outpatient procedures (n=4,300,000). Ambulatory surgery centers (ASCs) vs. Hospital-based outpatient departments (HOPDs) was evaluated on Mean patient-to-emergency department (ED) distance (12.4% increase). The mean patient-to-emergency department distance for outpatient procedures increased by 12.4% between 2005 and 2007, driven by a shift toward ambulatory surgery centers.
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