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Ambulatory surgical centers

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https://www.readbyqxmd.com/read/29200371/comparison-of-anesthesia-for-dental-oral-surgery-by-office-based-dentist-anesthesiologists-versus-operating-room-based-physician-anesthesiologists
#1
Mark A Saxen, Richard D Urman, Juan F Yepes, Rodney A Gabriel, James E Jones
Few studies have examined the practice characteristics of dentist anesthesiologists and compared them to other anesthesia providers. Using outcomes from the National Anesthesia Clinical Outcomes Registry and the Society for Ambulatory Anesthesia Clinical Outcomes Registry for dental/oral surgery procedures, we compared 7133 predominantly office-based anesthetics by dentist anesthesiologists to 106,420 predominantly operating room anesthetics performed by physician anesthesia providers. These encounters were contrasted with 34,191 previously published encounters from the practices of oral and maxillofacial surgeons...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/29194621/effects-of-the-medicare-modernization-act-on-spending-for-outpatient-surgery
#2
John M Hollingsworth, Mary K Oerline, Chandy Ellimoottil, Lindsey A Herrel, Brent K Hollenbeck
OBJECTIVES: To examine the effects of Medicare's revised ambulatory surgery center (ASC) payment schedule on overall payments for outpatient surgery. DATA SOURCES: Twenty percent sample of national Medicare beneficiaries. STUDY DESIGN: We conducted a pre-post study of Medicare beneficiaries who underwent outpatient surgery in a hospital outpatient department (HOPD), ASC, or physician office between 2004 and 2011. Specifically, we used multivariable regression to compare temporal trends in outpatient surgery before and after implementation of Medicare's revised payment schedule in 2008, which reduced ASC facility payments to roughly two-thirds that of HOPDs...
November 30, 2017: Health Services Research
https://www.readbyqxmd.com/read/29186597/factors-for-a-good-surgical-outcome-in-posterior-decompression-and-dekyphotic-corrective-fusion-with-instrumentation-for-thoracic-ossification-of-the-posterior-longitudinal-ligament-prospective-single-center-study
#3
Shiro Imagama, Kei Ando, Kazuyoshi Kobayashi, Tetsuro Hida, Kenyu Ito, Mikito Tsushima, Yoshimoto Ishikawa, Akiyuki Matsumoto, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Hiroaki Nakashima, Yoshihiro Nishida, Yukihiro Matsuyama, Naoki Ishiguro
BACKGROUND: Surgery for thoracic ossification of the posterior longitudinal ligament (T-OPLL) is still challenging, and factors for good surgical outcomes are unknown. OBJECTIVE: To identify factors for good surgical outcomes with prospective and comparative study. METHODS: Seventy-one consecutive patients who underwent posterior decompression and instrumented fusion were divided into good or poor outcome groups based on ≥50% and <50% recovery rates for the Japanese Orthopaedic Association score...
December 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29167902/trends-in-use-of-ambulatory-surgery-centers-for-cataract-surgery-in-the-united-states-2001-2014
#4
Brian C Stagg, Nidhi Talwar, Cynthia Mattox, Paul P Lee, Joshua D Stein
Importance: Cataract surgery is commonly performed at ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). These venues differ in many ways, including surgical efficiency, patient throughput, patient safety, and costs per surgery. Objective: To determine trends in use of ASCs and HOPDs for cataract surgery from 2001 to 2014 and factors affecting the site of surgery. Design, Setting, and Participants: This retrospective longitudinal cohort analysis involved individuals 40 years and older who underwent cataract surgery between January 2001 and December 2014 from a nationwide US managed care network...
November 22, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29148356/specialization-as-an-organizing-principle-the-case-of-ambulatory-surgery-centers
#5
Kathleen Carey, Jean M Mitchell
Ambulatory surgery centers (ASCs) recently have grown to become the dominant provider of specific surgical procedures in the United States. While the majority of ASCs focus primarily on a single specialty, many have diversified to offer a wide range of surgical specialties. We exploited a unique data set from Pennsylvania for the years 2004 to 2014 to conduct an empirical investigation of the relative cost of production in ASCs over varying degrees of specialization. We found that for the majority of ASCs, focus on a specialty was associated with lower facility costs...
August 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29145986/hand-surgery-in-the-ambulatory-surgery-center
#6
REVIEW
Norfleet B Thompson, James H Calandruccio
Outpatient surgery, especially in free-standing ambulatory surgery centers (ASC), provides a safe, cost-effective option for a variety of surgical procedures and has become the preferred choice over inpatient and hospital-based outpatient surgery for most hand and wrist procedures. Complication rates after ASC hand surgery are low (0.2%-2.5%). Patient dissatisfaction with ASC surgery is primarily associated with postoperative nausea and vomiting and inadequate pain control.
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29125521/variation-in-surgical-management-of-neurogenic-bowel-among-centers-participating-in-national-spina-bifida-patient-registry
#7
Jonathan C Routh, David B Joseph, Tiebin Liu, Michael S Schechter, Judy K Thibadeau, M Chad Wallis, Elisabeth A Ward, John S Wiener
PURPOSE: Optimal management of neurogenic bowel in patients with spina bifida (SB) remains controversial. Surgical interventions may be utilized to treat constipation and provide fecal continence, but their use may vary among SB treatment centers. METHODS: We queried the National Spina Bifida Patient Registry (NSBPR) to identify patients who underwent surgical interventions for neurogenic bowel. We abstracted demographic characteristics, SB type, functional level, concurrent bladder surgery, mobility, and NSBPR clinics to determine whether any of these factors were associated with interventions for management of neurogenic bowel...
October 20, 2017: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/29122620/three-year-outcomes-of-the-prospective-randomized-controlled-rez%C3%A5-m-system-study-convective-radiofrequency-thermal-therapy-for-treatment-of-lower-urinary-tract-symptoms-due-to-benign-prostatic-hyperplasia
#8
Kevin T McVary, Claus G Roehrborn
OBJECTIVE: To report 3-year outcomes of a prospective, multi-center, randomized, blinded control trial after treatment with convective radiofrequency (RF) water vapor thermal therapy for moderate to severe lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Fifteen centers enrolled and randomized 197 men ≥50 years old with International Prostate Symptom Score (IPSS) ≥13, maximum flow rate (Qmax) ≤15 ml/s and prostate volume 30 to 80 cc to thermal therapy with Rezūm® System or control (2:1)...
November 6, 2017: Urology
https://www.readbyqxmd.com/read/29103779/is-outpatient-unicompartmental-knee-arthroplasty-safe-to-perform-at-an-ambulatory-surgery-center-a-comparative-study-of-early-post-operative-complications
#9
John P Cody, Kiel J Pfefferle, Deborah J Ammeen, Kevin B Fricka
BACKGROUND: Unicompartmental knee arthroplasty (UKA) lends itself to the outpatient surgical setting. Prior literature has established a low rate of readmission and post-operative complications when performed in a hospital outpatient setting (HOP). To our knowledge, there have been no studies comparing complications of UKA performed at an ambulatory surgery center (ASC) and those in a HOP. METHODS: We retrospectively reviewed all patients who underwent outpatient UKA by a single surgeon from 2012 to 2016...
October 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29078868/hospital-readmission-after-ambulatory-laparoscopic-cholecystectomy-incidence-and-predictors
#10
Eric B Rosero, Girish P Joshi
BACKGROUND: The aim of the study was to assess the rate of 30-d hospital readmissions after ambulatory laparoscopic cholecystectomy. MATERIALS AND METHODS: The 2009 to 2011 State Ambulatory Surgery and Services and State Inpatient Databases from California, Florida, and New York were analyzed to evaluate the incidence of 30-d readmissions after laparoscopic cholecystectomy performed in outpatient settings. Hospital transfers and the principal diagnoses of hospital readmission were analyzed as secondary outcomes...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29062640/10-years-later-lessons-learned-from-an-academic-multidisciplinary-cosmetic-center
#11
Jenny T Chen, Harry S Nayar, Venkat K Rao
BACKGROUND: In 2006, a Centers for Medicare and Medicaid Services-accredited multidisciplinary academic ambulatory surgery center was established with the goal of delivering high-quality, efficient reconstructive, and cosmetic services in an academic setting. We review our decade-long experience since its establishment. METHODS: Clinical and financial data from 2006 to 2016 are reviewed. All cosmetic procedures, including both minimally invasive and operative cases, are included...
September 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29059083/current-opinions-in-office-based-rhinology
#12
Aykut A Unsal, Naomi Gregory, Kenneth Rosenstein
PURPOSE OF REVIEW: The care of rhinologic patients has undergone a remarkable transformation in recent years. With the advent of endoscopic sinus surgery and high-tech image-guided computer systems, the surgical care of patients with benign sinonasal disease has successfully transitioned from the main hospital operating room to the outpatient ambulatory surgical center. Currently, there is yet another movement underway, in an attempt to care for these patients in the office setting. RECENT FINDINGS: As the medical device sector continues to innovate at rapid speed, new technologies such as the radiofrequency ablator, microdebrider, balloon sinus dilator, and steroid-eluting stent have propelled the care of rhinologic patients into the clinic setting...
October 20, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29053655/assessment-of-pre-and-postoperative-anxiety-in-patients-undergoing-ambulatory-oral-surgery-in-primary-care
#13
E Reyes-Gilabert, L-G Luque-Romero, G Bejarano-Avila, A Garcia-Palma, A Rollon-Mayordomo, P Infante-Cossio
BACKGROUND: To analyze the pre- and postoperative anxiety level in patients undergoing ambulatory oral surgery (AOS) in a primary healthcare center (PHC). MATERIAL AND METHODS: Prospective and descriptive clinical study on 45 patients who underwent AOS procedures in the dental clinic of a public PHC of Spain between April and September 2015. Anxiety analysis was carried out with pre- and postoperative anxiety-state (STAI-S), anxiety-trait (STAI-T) and dental anxiety (MDAS) questionnaires...
November 1, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/29045566/aesthetic-surgical-procedures-in-men-major-complications-and-associated-risk-factors
#14
Christodoulos Kaoutzanis, Julian Winocour, Max Yeslev, Varun Gupta, Ishan Asokan, Jason Roostaeian, James C Grotting, K Kye Higdon
Background: The number of men undergoing cosmetic surgery is increasing in North America. Objectives: To determine the incidence and risk factors of major complications in males undergoing cosmetic surgery, compare the complication profiles between men and women, and identify specific procedures that are associated with higher risk of complications in males. Methods: A prospective cohort of patients undergoing cosmetic surgery between 2008 and 2013 was identified from the CosmetAssure database...
October 14, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29045170/high-glucose-variability-in-hospitalized-patients-with-type-1-diabetes-mellitus
#15
Vikash Dadlani, Shrikant U Tamhane, Aidong Sun, Anu Sharma, Danae A Delivanis, Prabin Thapa, Ricky E Carter, Yogish C Kudva
BACKGROUND: Glucose variability (GV) has been increasingly (or more extensively) studied in patients with type 1 diabetes (T1D) in the ambulatory setting; limited data exist on GV in hospitalized patients with T1D. MATERIALS AND METHODS: Retrospective single center cohort study, we analyzed in-hospital glucose measurements to assess GV in 736 hospitalized patients in different units over a consecutive 5-year period of time. GV was assessed by mean blood glucose (BG), Average daily risk range (ADRR), high BG index, and low BG index...
October 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28948182/postdischarge-outcomes-of-pyogenic-liver-abscesses-single-center-experience-2007-2012
#16
Megan C Gallagher, Mary-Margaret Andrews
BACKGROUND: Pyogenic liver abscesses (PLA) are increasingly managed by percutaneous treatment instead of surgery, but there are limited data about postdischarge outcomes. Postdischarge services and factors predicting poor outcomes have not been described. METHODS: We performed a retrospective, descriptive case series at a single center assessing treatment and outpatient follow-up for patients treated for PLA from 2007 to 2012. We reviewed the electronic medical record for patient characteristics and outcomes...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28927566/low-rates-of-adverse-events-following-ambulatory-outpatient-total-hip-arthroplasty-at-a-free-standing-surgery-center
#17
Patrick C Toy, Matthew N Fournier, Thomas W Throckmorton, William M Mihalko
BACKGROUND: We proposed to determine the complication and hospital admission rates for patients with total hip arthroplasty (THA) done by a single surgeon in a stand-alone ambulatory surgical center with same-day discharge. Given the recent emphasis on bundled payments for a 90-day episode of care, this same time frame after surgery was chosen to determine patient outcomes. METHODS: The records of patients with THAs done through a direct anterior approach by a single surgeon at 2 separate ambulatory surgery centers were reviewed...
August 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28923189/gender-differences-in-sleep-disorders-in-the-us-military
#18
Shannon N Foster, Shana L Hansen, Dale C Capener, Panagiotis Matsangas, Vincent Mysliwiec
OBJECTIVES: The purpose of this study is to compare sleep disorders between male and female military personnel. Comorbid behavioral health disorders and chronic pain were also studied in relation to sleep disorders. DESIGN: We conducted a retrospective review of military personnel who underwent a sleep medicine evaluation and an in-laboratory attended polysomnography. Initial sleep questionnaires, demographics, polysomnographic variables, and comorbid disorders of interest were reviewed and compared for each sex...
October 2017: Sleep Health
https://www.readbyqxmd.com/read/28914276/appropriate-reconciliation-of-cardiovascular-medications-after-elective-surgery-and-postdischarge-acute-hospital-and-ambulatory-visits
#19
Jonathan S Lee, Ralph Gonzales, Eric Vittinghoff, Kitty K Corbett, Kirsten E Fleischmann, Neil Sehgal, Andrew D Auerbach
OBJECTIVE: To describe appropriate discharge reconciliation of cardiovascular medications and assess associations with postdischarge healthcare utilization in surgical patients. DESIGN: Retrospective cohort study from January 2007 to December 2011. SETTING: An academic medical center. PATIENTS: Seven hundred and fifty-two adults undergoing elective noncardiac surgery and taking antiplatelet agents, beta-blockers, renin-angiotensin system inhibitors, or statin lipid-lowering agents before surgery...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28900775/specialization-and-production-cost-efficiency-evidence-from-ambulatory-surgery-centers
#20
Kathleen Carey, Jean M Mitchell
In the U.S. health care sector, the economic logic of specialization as an organizing principle has come under active debate in recent years. An understudied case is that of ambulatory surgery centers (ASCs), which recently have become the dominant provider of specific surgical procedures. While the majority of ASCs focus on a single specialty, a growing number are diversifying to offer a wide range of surgical services. We take a multiple output cost function approach to an empirical investigation that compares production economies in single specialty ASCs with those in multispecialty ASCs...
September 12, 2017: International Journal of Health Economics and Management
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