Outpatient Ambulatory Surgical Centers May Cut Costs without Cutting Quality

Two things that tend to rise in health care are the number of patients who need care and the costs associated with that care. That said, one sector of healthcare may actually be able to reduce costs and more efficiently care for patients: ambulatory surgery.

Ambulatory surgery is essentially synonymous with same-day surgery, where discharge occurs within 23 hours after the surgical procedure is finished.Outpatient ambulatory surgical centers specialize in providing only same-day surgical procedures. These centers are not hospitals nor are they primary care clinics. They are not an urgent care facility or emergency department. They simply provide one thing and do it very well, ambulatory surgery.

Ambulatory surgical centers do not provide sophisticated diagnostics. While some centers provide basic radiological services, most imaging studies and diagnostic tests have already been performed by the time the patient arrives at the ambulatory surgical center.

The only absolute requirement is that the surgical procedure and the patient must be truly “ambulatory.”If the patient is not ambulatory or requires complex postoperative support, then his or her surgery will likely take place in a larger surgical center or hospital.

Perhaps because of this specialization, ambulatory surgical centers have done what most people assume is impossible, they have reduced healthcare costs. At the same time, patients are just as satisfied or more satisfied with traditional surgical venues.

There are several reasons for this reduction healthcare cost without sacrificing the quality of care. The ambulatory surgical center model reduces wait time for surgeries by diverting more routine surgeries away from hospital based surgery centers. They also allow hospital-based surgeons to focus on procedures that are more complex or that require substantial postoperative care. Likewise, patients at higher surgical risk (e.g., anesthesia poses a risk, patients with multiple chronic health conditions and/or poor overall health) are managed and larger centers with varied staff and the broader range of service options.

Complex procedures or patients with multiple conditions require the services of a hospital based surgery and recovery center. These patients often need multi-day hospitalization and occupy beds much longer than patients who could have been treated at one of these outpatient surgery centers.

The surgical procedures that are performed at ambulatory surgical centers tend to be minimally invasive with extremely low intraoperative risk and high short-term success rates. Perhaps the prototypical example of an ambulatory surgical procedure is an anterior cervical discectomy and fusion or ACDF.

An anterior cervical discectomy and fusion is the standard procedure to treat a herniated disc in the cervical spine. While the surgery is rather delicate, because it is a spine surgery, experience spine surgeons can perform an anterior cervical discectomy and fusion rather efficiently with a small incision and minimal blood loss.

In a study of over 1,000 anterior cervical discectomy and fusion procedures, one ambulatory surgical center reported surgical success rates as high as hospital centers, and every patient was able to go home the same day of the procedure. Moreover, costs were reduced between 30 and 70% over those who had the procedure done at a hospital. A 30% reduction alone grabs attention, but a 70% cost reduction demands it.

Same-day surgeries performed outside of a hospital setting are apparently as safe and effective as the same surgeries performed in hospitals. Patients are also quite satisfiedbecause they can get the surgical procedure they need and then get back to their lives as quickly as possible.

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