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May 02, 2024
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Surgical volume may be an indicator of quality of care in ASCs

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Key takeaways:

  • Results showed low-volume ASCs were associated with increased odds of hospital revisit.
  • Patients with multimorbidity were especially at risk for revisit in low-volume centers.

Results from a matched case-control study showed surgical volume and multimorbidity status may be indicators of patient outcomes in ASCs.

“As in hospitals, the procedure volume of the ambulatory surgery centers is an important predictor of patient outcomes, and higher-volume ambulatory surgery centers are associated with better ambulatory surgery outcomes,” the researchers wrote in the study. “This is especially true in patients with multimorbidity.”

OT0124Jain_Graphic_01
Data were derived from Jain S, et al. JAMA Surg. 2024;doi:10.1001/jamasurg.2023.7161.

To examine the relationship between surgical volume and quality of care at ASCs, researchers matched 4,751 patients aged at least 66 years who revisited the hospital within 7 days of a surgical procedure with 23,755 control patients without revisits. Researchers also analyzed the impact of multimorbidity status on patient outcomes.

ASCs were categorized as either low volume if there were fewer than 50 procedures during the study period or high volume if there were more than 50 procedures during the study period.

Overall, researchers found patients treated at low-volume ASCs had increased odds of a 7-day revisit vs. patients treated at high-volume ASCs.

In addition, researchers found patients with multimorbidity who underwent orthopedic procedures had 84% higher odds of a revisit at a low-volume center vs. a high-volume center, while patients with multimorbidity who underwent general surgery or other procedures had 36% higher odds of a revisit at a low-volume center vs. a high-volume center.

“Surgery for older individuals in the U.S. is increasingly being performed at ambulatory surgery centers, while the number of older patients with multimorbidity has been steadily increasing,” researchers wrote in the study. “We found that patients with multimorbidity had worse outcomes in low-volume ambulatory surgery centers than in higher-volume ambulatory surgery centers. The worse outcomes were found at low-volume ambulatory surgery centers for patients with multimorbidity, but not for patients without multimorbidity.”

“Older patients with multimorbidity should discuss with their surgeon the optimal location of care,” they concluded.