Journal of clinical anesthesia
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The US Agency for Healthcare Research and Quality's State Ambulatory Surgery Database includes procedures performed at hospital outpatient surgery departments. We hypothesized that, among US hospitals with an anesthesia department and freestanding outpatient surgical center, the prevalence on hospital campuses (i.e., within 250 yards of the main hospital building) would be sufficiently large (e.g., >10%) to influence interpretation of observational studies performed with US national ambulatory surgery datasets. ⋯ The percentage of freestanding surgery centers located within 250 yards of main hospital buildings is sufficiently large to influence analyses. When using US national data, ambulatory surgery reported as performed at a hospital should not be considered as having been performed within the hospital. Similarly, hospital affiliated freestanding surgery centers should not be assumed to be more than a 5 min walk for anesthesia and operating room personnel from the hospital.
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Comparative Study
Heterogeneity among hospitals statewide in percentage shares of the annual growth of surgical caseloads of inpatient and outpatient major therapeutic procedures.
Suppose that it were a generalizable finding, in both densely populated and rural states, that there is marked heterogeneity among hospitals in the percentage change in surgical caseload and/or in the total change in caseload. Then, individual hospitals should not simply rely on federal and state forecasts to infer their expected growth. Likewise, individual hospitals and their anesthesiology groups would best not rely on national or US regional surgical trends as causal reasons for local trends in caseload. We examined the potential utility of using state data on surgical caseload to predict local growth by using 6 years of data for surgical cases performed at hospitals in the States of Florida and Iowa. ⋯ Even if the data from states or federal agencies reported growth in surgical cases, there is too much concentration of growth at a few hospitals for statewide growth rates to be useful for forecasting by individual hospitals and anesthesiology groups.