Outpatient surgery: Difference between revisions

'''Outpatient surgery''', also known as '''ambulatory surgery''', '''day surgery''',<ref name=LemosIAAS2006>{{cite book |name-list-style=vanc | editor1-last=Lemos |editor1-first=P |editor2-last=Jarrett |editor2-first=P |editor3-last=Philip |editor3-first=B| title = Day surgery: development and practice | publisher = International Association for Ambulatory Surgery | location = London | year = 2006 | isbn = 9892002342 |url=http://www.iaas-med.com/files/historical/DaySurgery.pdf|access-date=2018-06-11}}</ref> '''day case surgery''', or '''same-day surgery''', is [[surgery]] that does not require an overnight [[hospital]] stay.<ref group=note>The [[International Association for Ambulatory Surgery]] (IAAS) would not consider all of these terms synonymous. In a 2003 document [http://www.iaas-med.com/files/historical/IAAS_definitions.pdf "Ambulatory (day) surgery: suggested international terminology and definitions"], the IAAS recommends defining an "outpatient" procedure as one "carried out in the outpatient department of a hospital" and an "ambulatory" procedure as one "excluding an office/surgery or outpatient operation/procedure, where the patient is discharged on the same working day." That is, "ambulatory surgery" occurs in an "ambulatory surgery center."</ref> The term “[[outpatient]]” arises from the fact that surgery patients may enter and leave the facility on the same day. The advantages of outpatient surgery over inpatient surgery include greater convenience and reduced costs.<ref name=LemosIAAS2006/>{{rp|24-2624–26}}

Outpatient surgery may occur in an inpatient facility, in a self-contained unit within a hospital (also known as a hospital outpatient department), in a freestanding self-contained unit (also known as an ambulatory surgery center), or in a physician's office-based unit.<ref name=LemosIAAS2006/>{{rp|61}} Between the late 20th century and early 21st century, outpatient surgery has grown in popularity in many countries.<ref name=LemosIAAS2006/>{{rp|22}} In the United States, 65% of surgeries at hospitals in 2012 were conducted on an outpatient basis, compared with 54% in 1992.<ref name=Wier2015>{{cite journal| vauthors=Wier LM, Steiner CA, Owens PL| title=Surgeries in hospital-owned outpatient facilities, 2012| journal=HCUP Statistical Brief #|issue=188 | date= Feb 2015| publisher=Agency for Healthcare Research and Quality|place=Rockville, Maryland| url=https://www.hcup-us.ahrq.gov/reports/statbriefs/sb188-Surgeries-Hospital-Outpatient-Facilities-2012.pdf|access-date=2018-06-11}}</ref>

These centers specialize in providing surgery, including certain [[pain management]] and [[diagnostic]] (e.g., eye muscle surgery services) in an [[outpatient]] setting. Overall, the services provided can be generally called '''procedures'''. These can be considered procedures that are more intensive than those done in the average doctor's office but not so intensive as to require a hospital stay. An ambulatory surgery center and a '''specialty hospital''' often provide similar facilities and support similar types of procedures. The specialty hospital may provide the same procedures or slightly more complex ones and the specialty hospital will often allow an overnight stay. ASCs do not routinely provide emergency services to patients who have not been admitted to the ASC for another procedure.

As of 2011, physicians performed more than 23 million procedures per year in over 5,300 ASCs in the United States.<ref name=ASCAHistory>{{Cite web|url=https://www.ascassociation.org/advancingsurgicalcare/asc/historyofascs|title=History of ASCs||author=Ambulatory Surgery Center Association|access-date=2018-06-11}}</ref>

In the 1980s and 1990s, many procedures that used to be performed exclusively in hospitals began taking place in ASCs as well. Many knee, shoulder, eye, spine and other surgeries are currently performed in ASCs. As of 2016, of procedures in ASCs funded by [[Medicare (United States)|Medicare in the United States]], the three most common were [[cataract surgery]] with [[intraocular lens]] insert (18.7% of all procedures), [[Esophagogastroduodenoscopy|upper gastrointestinal endoscopy]] with [[biopsy]] (8.2%), and colonoscopy with biopsy (6.8%).<ref name=MedPAC2018>{{cite web |url=http://medpac.gov/docs/default-source/reports/mar18_medpac_entirereport_sec.pdf |title= Report to the Congress: Medicare payment policy |author=<!--Not stated--> |publisher=[[Medicare Payment Advisory Commission]] | date= March 2018 |access-date=2018-06-11|name-list-format=vanc}}</ref>

Effective in 1996, California was the first state in the United States to require accreditation for all outpatient surgery settings that administer anesthesia.<ref name=McGuire2013>{{cite journal| vauthors=McGuire MF| title=International accreditation of ambulatory surgical centers and medical tourism | journal=Clin Plast Surg | year= 2013 | volume= 40 | issue= 3 | pages= 493-8493–8 | pmid=23830758 | doi=10.1016/j.cps.2013.04.013 | url=https://www.plasticsurgery.theclinics.com/article/S0094-1298(13)00038-2/pdf|access-date=2018-06-10}}</ref><ref name=AB595>{{cite web |url=http://www.leginfo.ca.gov:80/pub/93-94/bill/asm/ab_0551-0600/ab_595_bill_940930_chaptered|title=Bill Number: AB 595 Chaptered |author=<!--Not stated-->| publisher=[[California State Legislature]]|date=1994-09-30|access-date=2018-06-10}}</ref> The [[Centers for Medicare and Medicaid Services]] have approved five organizations to accredit ASCs: [[Accreditation Association for Ambulatory Health Care]] (AAAHC), American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), [[Healthcare Facilities Accreditation Program]] (HFAP), Institute for Medical Quality (IMQ), and [[Joint Commission|The Joint Commission]] (TJC).<ref name=CMSApproved2018>{{cite web |url=https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Accrediting-Organization-Contacts-for-Prospective-Clients-.pdf|title= CMS-Approved Accrediting Organization Contacts for Prospective Clients|author=<!--Not stated--> |publisher=[[Centers for Medicare and Medicaid Services]]| date= 2018-01-10|access-date=2018-06-10|name-list-format=vanc}}</ref>

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