Short-term outcomes for outpatient procedures unaffected by facility type

Use of non-hospital ambulatory facilities as the setting for common outpatient urologic procedures does not appear to adversely affect short-term patient morbidity or mortality, according to researchers from the University of Michigan, Ann Arbor.

"There has been a gradual movement over the past two decades in the use of outpatient facilities that are separate from the hospital," observed first author John M. Hollingsworth, MD, MS. "While there have been studies looking at patient satisfaction, as well as implications of this movement of procedures on the cost of care, there has been little work really assessing what sort of outcomes are related to this transition."

In the study presented by co-author Christopher P. Filson, MD, MS, investigators utilized Medicare data to identify patients who had undergone one of 20 common outpatient urologic procedures between 1998 and 2006. Outcomes (same-day and subsequent hospitalizations, complications, and death within 30 days) were stratified by procedural setting.

Whereas the proportion of procedures performed at ambulatory surgery centers remained relatively constant throughout the evaluation period, the percentage of procedures performed in physician offices increased over time at the expense of hospital outpatient department-based procedures.

Dr. Hollingsworth noted that while some advantage was observed in favor of outpatient facilities, the magnitude of the difference was small, and outcomes may have been influenced by an apparent selection bias toward the treatment of younger and healthier patients in physician offices and ambulatory surgery centers.