First week after surgery, need for acute care grows
You probably know that among ambulatory surgery center (ASC) patients, it’s rare for patients to need to be transferred to a hospital at the time of discharge. However, you might not know that in the first week afterward, the need for hospital-based acute care is nearly 30-fold greater, according to recently published research.1
The need for acute care varies across surgery centers, and it might be a meaningful quality benchmark, according to the researchers.
The researchers look at data from the Healthcare Cost and Utilization Project (HCUP) and identified adult patients who underwent a medical procedure or surgery between July 2008 and September 2009 at ASCs in California, Florida, and Nebraska. The primary outcomes were hospital transfer at the time of discharge and hospital-based acute care (emergency department visits or hospital admissions) within seven days. Rates were adjusted for age, sex, and procedure-mix.
The researchers studied 3.8 million patients treated at 1,295 ASCs. At discharge, the hospital transfer rate was 1.1 per 1,000 discharges (95% confidence interval 1.11.1). Among patients discharged home, the hospital-based, acute care rate was 31.8 per 1,000 discharges (95% confidence interval 31.632.0). Across ASCs, there was not much variation in adjusted hospital transfer rates (median = 1.0/1,000 discharges [25th75th percentile = 1.02.0]), but there was substantial variation in adjusted, hospital-based acute care rates (28.0/1,000 [21.039.0]).
- Fox JP, Vashi AA, Ross JS, et al. Hospital-based, acute care after ambulatory surgery center discharge. Surgery 2014; 155(5): 743-753. Web: http://www.surgjournal.com/article/S0039-6060(13)00627-2/abstract.
