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Ambulatory surgical centers

Alla Guekht, Maria Mizinova, Igor Kaimovsky, Oksana Danilenko, Elisa Bianchi, Ettore Beghi
OBJECTIVE: The objective of this study was to investigate prospectively the direct costs of epilepsy in Russia, taking a patient perspective and a bottom-up approach. METHODS: The study was conducted in adolescents and adults with epilepsy seen in the ambulatory services of a city hospital in Moscow. Patients were assigned to different prognostic categories: newly diagnosed epilepsy; epilepsy in remission for 2+years; epilepsy in remission for <2years or with occasional seizures; active, nondrug-resistant epilepsy; drug-resistant epilepsy; and drug-resistant epilepsy in surgical candidates...
October 10, 2016: Epilepsy & Behavior: E&B
Christodoulos Kaoutzanis, Varun Gupta, Julian Winocour, Bruce Shack, James C Grotting, Kent Higdon
BACKGROUND: Surgical site infections (SSIs) represent one of the most common postoperative complications in patients undergoing aesthetic surgery. OBJECTIVES: This study reports the incidence and risk factors of major SSIs following aesthetic surgery. METHODS: A prospective cohort of patients who underwent aesthetic surgery between 2008 and 2013 was identified from the CosmetAssure database. Primary outcome was occurrence of a major SSI requiring emergency room visit, hospital admission, or reoperation within 30 days of the index operation...
September 30, 2016: Aesthetic Surgery Journal
Rachel M Kacmar, Brian M Davidson, Matthew Victor, Ken Bullard, Jose Melendez
STUDY OBJECTIVE: The objective was to analyze if an at-risk salary model for faculty anesthesiologists could improve on-time first case starts (FCSs) and case turnovers (TOs) in an academic hospital inpatient operating room (IOR) and ambulatory surgery center (ASC). Organizational goals were 65% and 70% on-time FCS and case TO times for IOR and ASC, respectively. DESIGN: This was a retrospective study. SETTING: Surgical cases performed at both the IORs and the ASCs at a large academic medical center were included...
November 2016: Journal of Clinical Anesthesia
Rachid Badaoui, Youssef Alami Chentoufi, Abdelhakim Hchikat, Lionel Rebibo, Ivan Popov, Abdennaceur Dhahri, Ghada Antoun, Jean-Marc Regimbeau, Emmanuel Lorne, Hervé Dupont
STUDY OBJECTIVE: The development of outpatient surgery was one of the major goals of public health policy in 2010. The purpose of this observational prospective study was to evaluate the feasibility of laparoscopic sleeve gastrectomy (SG) in an ambulatory setting. DESIGN: Study design was a prospective prospective observational, nonrandomized study, registered ( identifier: NCT01513005), with institutional review board approval and written informed consent...
November 2016: Journal of Clinical Anesthesia
Amanda Pereira Lima, Felipe José Vieira, Gabriela Procópio DE Moraes Oliveira, Plínio Dos Santos Ramos, Marielle Elisa Avelino, Felipe Garcia Prado, Gilson Salomão, Francisco Campos Silva, João Vicente Linhares Rodrigues
OBJECTIVE: to describe the clinical and epidemiological profile of acute appendicitis (AA) of the patients treated at a referral center in the Juiz de Fora macro-region, Minas Gerais State, Brazil. METHODS: we conducted a retrospective, observational study in the Dr. Mozart Geraldo TeixeiraEmergency Hospital. We selected 638 patients diagnosed with AA, and analyzed the variables gender, age, evolutionary phase, length of hospital stay, pathological diagnosis, use of antibiotics, use of drains, complications and mortality...
July 2016: Revista do Colégio Brasileiro de Cirurgiões
Emily A Slopnick, Adonis K Hijaz, Carvell T Nguyen, Robert Abouassaly, Christopher M Gonzalez, Sangeeta T Mahajan, J Welles Henderson, Matthew J Bream, Simon P Kim
OBJECTIVES: To determine contemporary trends, patient characteristics, and outcomes for mid-urethral sling placement (MUS) at inpatient and ambulatory facilities from a national database. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program data base, we identified 7,767 women who underwent isolated MUS 2006-2012. We stratified patients by hospitalization type (outpatient vs. hospitalization). Primary outcomes were 30-day complications, readmissions, and reoperations...
September 23, 2016: Urology
George Molina, Bridget A Neville, Stuart R Lipsitz, Lorri Gibbons, Ashley Kay Childers, Atul A Gawande, William R Berry, Alex B Haynes
BACKGROUND: Surgical procedures in the United States are increasingly performed in the ambulatory setting, including freestanding ambulatory surgery centers (ASCs). However, there is a lack of research and tracking of surgical outcomes in this setting. MATERIALS AND METHODS: We analyzed data from a state all-payer claims database to produce a retrospective cohort study on the rate of acute care use (emergency department [ED] visits and inpatient admissions) within 7 d after operations performed in freestanding ASCs in South Carolina...
October 2016: Journal of Surgical Research
Feryal Erhun, Elizabeth Malcolm, Maziyar Kalani, Kimberly Brayton, Christine Nguyen, Steven M Asch, Terry Platchek, Arnold Milstein
OBJECTIVES: Nearly 57 million outpatient surgeries-invasive procedures performed on an outpatient basis in hospital outpatient departments (HOPDs) or ambulatory surgery centers (ASCs)-produced annually in the United States account for roughly 7% of healthcare expenditures. Although moving inpatient surgeries to outpatient settings has lowered the cost of care, substantial opportunities to improve the value of outpatient surgery remain. To exploit these remaining opportunities, we composed an evidence-based care delivery composite for national discussion and pilot testing...
2016: American Journal of Managed Care
César A Briceño, Molly L Fuller, Elizabeth A Bradley, Christine C Nelson
PURPOSE: To evaluate the Abbreviated National Eye Institute Visual Function Questionnaire (NEI VFQ 9), which is shorter than those previously published, as a tool for assessing vision-related quality of life in patients with ptosis and dermatochalasis. METHODS: This is a cohort study of 46 patients who underwent blepharoptosis and/or upper eyelid blepharoplasty surgery by a single surgeon (CN) in 2013 in a public, academic, ambulatory care referral center. Patients included 29 who underwent blepharoplasty, 11 who underwent ptosis surgery, and 6 who underwent combined surgery...
July 2016: Arquivos Brasileiros de Oftalmologia
Diwakar D Balachandran, Saadia A Faiz, Mike Hernandez, Alicia M Kowalski, Lara Bashoura, Farzin Goravanchi, Sujith V Cherian, Elizabeth Rebello, Spencer S Kee, Katy E French
Background. The STOP-BANG questionnaire has been used to identify surgical patients at risk for undiagnosed obstructive sleep apnea (OSA) by classifying patients as low risk (LR) if STOP-BANG score < 3 or high risk (HR) if STOP-BANG score ≥ 3. Few studies have examined whether postoperative complications are increased in HR patients and none have been described in oncologic patients. Objective. This retrospective study examined if HR patients experience increased complications evidenced by an increased length of stay (LOS) in the postanesthesia care unit (PACU)...
2016: Anesthesiology Research and Practice
Varun Gupta, Rikesh Parikh, Lyly Nguyen, Ashkan Afshari, R Bruce Shack, James C Grotting, K Kye Higdon
BACKGROUND: There has been a dramatic rise in office-based surgery. However, due to wide variations in regulatory standards, the safety of office-based aesthetic surgery has been questioned. OBJECTIVES: This study compares complication rates of cosmetic surgery performed at office-based surgical suites (OBSS) to ambulatory surgery centers (ASCs) and hospitals. METHODS: A prospective cohort of patients undergoing cosmetic surgery between 2008 and 2013 were identified from the CosmetAssure database (Birmingham, AL)...
August 23, 2016: Aesthetic Surgery Journal
Sarah A Brownlee, Robert H Blackwell, Barbara A Blanco, Matthew A C Zapf, Stephanie Kliethermes, Gopal N Gupta, Paul C Kuo, Anai N Kothari
OBJECTIVE: The aim of this study was to investigate whether post-hospital syndrome (PHS) places patients undergoing elective hernia repair at increased risk for adverse postoperative events. SUMMARY OF BACKGROUND DATA: PHS is a transient period of health vulnerability following inpatient hospitalization for acute illness. PHS has been well studied in nonsurgical populations, but its effect on surgical outcomes is unclear. METHODS: State-specific datasets for California in 2011 available through the Healthcare Cost and Utilization Project (HCUP) were linked...
August 17, 2016: Annals of Surgery
Rishi Parikh, Daniel Pollock, Jyotirmay Sharma, Jonathan Edwards
OBJECTIVE We compared risk for surgical site infection (SSI) following surgical breast procedures among 2 patient groups: those whose procedures were performed in ambulatory surgery centers (ASCs) and those whose procedures were performed in hospital-based outpatient facilities. DESIGN Cohort study using National Healthcare Safety Network (NHSN) SSI data for breast procedures performed from 2010 to 2014. METHODS Unconditional multivariate logistic regression was used to examine the association between facility type and breast SSI, adjusting for American Society of Anesthesiologists (ASA) Physical Status Classification, patient age, and duration of procedure...
October 2016: Infection Control and Hospital Epidemiology
C E Schmidt, T Schuldt, A Kaiser, P Letzgus, J Liebeneiner, K Schmidt, A Öner, R Mlynski
BACKGROUND: Otorhinolaryngology (ENT) departments are strongly affected by current changes in the reimbursement schemes for inpatients. The study was designed to investigate these effects on the ENT Department in Rostock and selected comparison clinics, as well as to outline solutions. METHODS: We analyzed diagnosis-related group (DRG) reports of the ENT Clinic at Rostock University Medical Center from 2013 to 2015, according to the size of the outpatient potential...
July 18, 2016: HNO
Nalini Vadivelu, Alice M Kai, Vijay Kodumudi, Jack M Berger
Ambulatory surgery is on the rise, with an unmet need for optimum pain control in ambulatory surgery centers worldwide. It is important that there is a proportionate increase in the availability of acute pain-management services to match the rapid rise of clinical patient load with pain issues in the ambulatory surgery setting. Focus on ambulatory pain control with its special challenges is vital to achieve optimum pain control and prevent morbidity and mortality. Management of perioperative pain in the ambulatory surgery setting is becoming increasingly complex, and requires the employment of a multimodal approach and interventions facilitated by ambulatory surgery pain specialists, which is a new concept...
2016: Journal of Pain Research
Judy J Panella
The experience of surgery can be extremely stressful for children and their family members. Many children's hospitals offer a formal surgical preparation program to patients and their families, usually led by a child life specialist. However, smaller hospitals or ambulatory surgery centers may not be able to use this approach to preparing children for surgery. In this scenario, the perioperative nurse is in the ideal position to provide developmentally appropriate surgical preparation and education at the bedside...
July 2016: AORN Journal
Stephanie M Gancarczyk, Eugene S Jang, Eric P Swart, Eric C Makhni, Rajendra Kumar Kadiyala
INTRODUCTION: Percutaneous trigger finger releases (TFRs) performed in the office setting are becoming more prevalent. This study compares the costs of in-hospital open TFRs, open TFRs performed in ambulatory surgical centers (ASCs), and in-office percutaneous releases. METHODS: An expected-value decision-analysis model was constructed from the payer perspective to estimate total costs of the three competing treatment strategies for TFR. Model parameters were estimated based on the best available literature and were tested using multiway sensitivity analysis...
July 2016: Journal of the American Academy of Orthopaedic Surgeons
Andrea Saporito, Luciano Anselmi, Alain Borgeat, José A Aguirre
STUDY OBJECTIVE: Short-acting regional anesthetics have already been successfully used for peripheral nerve blocks in an ambulatory surgery setting. However, the impact on direct and indirect perioperative costs comparing 2 different short-acting local anesthetics has not been performed yet. DESIGN: Observational, prospective, case-control, cost-minimization study. SETTING: Operating room, regional hospital PATIENTS: One hundred adult American Society of Anesthesiologists status I-III patients scheduled for popliteal block after minor ambulatory foot surgery...
August 2016: Journal of Clinical Anesthesia
Dustin D French, Curtis E Margo, Robert R Campbell, Paul B Greenberg
Cataract is the most common surgically reversible cause of vision loss and the most common major surgical procedure performed in the United States. To understand how gender composition might affect differences in health services, we examined the surgeon gender-specific rates of routine cataract surgery performed in ambulatory surgical centers in Florida. Routine cataract surgeries were identified through the Florida Agency for Health Care Administration (AHCA) ambulatory surgery center dataset. The background of individual surgeons was determined by linking license numbers in the dataset to physician profiles publicly available from AHCA...
March 2016: Journal of Medical Practice Management: MPM
Elham Mahmoudi, Frank Yuan, Meghan E Lark, Oluseyi Aliu, Kevin C Chung
BACKGROUND: Despite equivalent outcomes among surgical treatments of thumb carpometacarpal arthritis, little is known about the variation in spending. Because of its complexities, the authors hypothesized that trapeziectomy with ligament reconstruction and tendon interposition incurs the greatest cost to Medicare compared with other surgical procedures. METHODS: Using a random 5 percent sample of Medicare beneficiaries diagnosed with thumb carpometacarpal joint arthritis, the authors examined total and out-of-pocket spending for 3530 patients who underwent a surgical treatment between 2001 and 2010...
June 2016: Plastic and Reconstructive Surgery
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