Changing access to emergency care for patients undergoing outpatient procedures at ambulatory surgery centers: Evidence from Florida

Mark D. Neuman, Guy David, Jeffrey H. Silber, J. Sanford Schwartz, Lee A. Fleisher

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)247-258
Number of pages12
JournalMedical Care Research and Review
Volume68
Issue number2
DOIs
StatePublished - Apr 2011

Keywords

  • access to care
  • ambulatory surgery
  • emergency care
  • geography

ASJC Scopus subject areas

  • Health Policy

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