Measuring five quality-based performance areas, an ambulatory surgical center out performed a standard hospital in otolaryngic surgeries, according to new research in the December 2009 issue of Otolaryngology – Head and Neck Surgery.
The cross-sectional study analyzed a total of 486 cases at a pediatric ambulatory surgical center (ASC) and a hospital-based facility (HBF). The cases comprised the four most common pediatric surgical procedures at the ASC compared to the HBF:
- Ventilation tube insertion.
- Dental rehabilitation.
- Ventilation tube insertion/adenoidectomy.
Only outpatient procedures were included.
The authors designed a series of quality performance measures based on the Institute of Medicine's multidimensional definition of quality. The study aimed to develop a better understanding of how an ASC might be a viable high-quality, low-cost organizational structure. The quality measures included safety, patient-centeredness, timeliness, efficiency and equitability.
Seventy-seven percent of ASC cases finished within the scheduled time compared to 38 percent at the HBF, a difference of about 30 percent. Total charges were 12 – 23 percent less at the ASC as well. However, patient satisfaction was similar between facilities. For the studied sample size, the ASC had no unexpected safety events, compared to nine at the HBF.
ASCs have been described as taking advantage of economies of scale and low-cost organizational structures. The authors note that although previous studies have shown the benefits of ASCs in one quality measure or another, this study is the first to explore multiple dimensions of quality in one surgical area to give a more complete picture.