STEINER CA, JOHANTGEN M, PANANGALA S; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2001; 17: abstract no. 245.

AHRQ, Rockville, MD. , University of Maryland, Baltimore, MD., Emory Univ., Atlanta, GA

Introduction - The rapid growth of ambulatory surgery in the US has raised concerns among patients, physicians and decision makers. These concerns have resulted in new state and Federal legislation. This study provides multi-state comparative rates of growth in the use of ambulatory surgery across grouped procedures.Methods - Data are from the Healthcare Cost and Utilization Project, a state-industry-federal partnership in administrative data. Ambulatory surgery(AS) and inpatient(IP) data are used from CO, CT, MD, NJ, NY, SC and UT for 1990-1997. Overall IP and AS rates per 10,000 population for each state and year are calculated. Procedures are limited to major-OR procedures as defined by ICD-9 coding to keep the state data more homogeneous. Procedures are grouped by body system, and rates per 10,000 are again calculated and rank ordered across the states. Finally, the estimated annual percentage change is calculated for each body grouping and each state to determine where the greatest growth in AS has occurred across the time period.Results - Across the 8 states, the rates of all major-OR procedures increased substantially from 275-360/10,000 in 1990 to 410-525/10,000 in 1997. IP rates decreased initially, from 540-570/10,000 in 1990, to 475-540/10,000 in 1995. However, after 1995, IP major-OR procedures began to increase across all 8 states. Rank-ordered rates of major-OR procedures in 1997 grouped by body system showed remarkable consistency. Across all 8 states, procedures in the musculoskeletal, eye, digestive and female body systems represented the highest rates of procedures among the 16 body groupings available. This contrasted sharply with rank-ordered rates for IP procedures in 1997. For instance, eye procedures were negligible as IP procedures, and OB, cardiovascular and male procedures were among the top 5. Interestingly, cardiovascular procedures demonstrated the largest annual percentage increase for ambulatory procedures, between 15% and 27% per year across the states. The next largest growth were in urinary procedures, followed by those in the musculoskeletal and digestive body systems.Conclusions - In the United States, there has been a consistently large increase in use of the AS setting for major-OR procedures. However, around the time that the first length-of-stay legislation was passed, IP major-OR procedures began to increase after several years of decline. There is consistency across the states in which body systems represent the greatest utilization in the AS setting. However, growth in the use of the AS setting is due to several procedures previously seen primarily as IP procedures.

Publication Types:

• Meeting Abstracts

Keywords:

• Ambulatory Surgical Procedures
• Female
• Humans
• Male
• United States
• methods
• surgery
• hsrmtgs

Other ID:

• GWHSR0002898

UI: 102274577

From Meeting Abstracts