September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
A major shift in ophthalmic surgical care in the United States from hospital outpatient departments to ambulatory surgery centers over the past decade
Author Affiliations & Notes
  • Brian Craig Stagg
    Ophthalmology, Univ of Utah School of Medicine, Salt Lake City, Utah, United States
  • Nidhi Talwar
    Department of Ophthalmology and Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan, United States
  • Cynthia Mattox
    Department of Ophthalmology, New England Eye Center, Tufts University School of Medicine, Boston, Massachusetts, United States
  • Paul P Lee
    Department of Ophthalmology and Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan, United States
    Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States
  • Joshua D Stein
    Department of Ophthalmology and Visual Sciences, University of Michigan, Medical School, Ann Arbor, Michigan, United States
    Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States
  • Footnotes
    Commercial Relationships   Brian Stagg, None; Nidhi Talwar, None; Cynthia Mattox, None; Paul Lee, None; Joshua Stein, None
  • Footnotes
    Support  Kellogg Foundation, Research to Prevent Blindness
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5578. doi:
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    • Get Citation

      Brian Craig Stagg, Nidhi Talwar, Cynthia Mattox, Paul P Lee, Joshua D Stein; A major shift in ophthalmic surgical care in the United States from hospital outpatient departments to ambulatory surgery centers over the past decade. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5578.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Utilization of ambulatory surgery centers (ASCs) is an alternative to traditional hospital outpatient departments (HOPDs) for ophthalmic surgery. The purpose of this study is to explore trends over the past decade in use of ASCs versus HOPDs for various types of ophthalmic surgeries among enrollees in a nationwide managed care network.

Methods : Claims data from 2001-2012 capturing patients enrolled in a large U.S. managed-care network were analyzed to identify all patients undergoing incisional ophthalmic surgery (cataract surgery, strabismus surgery, cornea surgery, glaucoma surgery, and retina surgery). For each type of ophthalmic surgery, we identified whether it took place at an ASC or HOPD. Each year from 2001-2012, we determined the proportion of each type of ophthalmic surgery performed at ASCs versus HOPDs.

Results : A total of 413530 patients underwent ≥1 type of incisional ophthalmic surgery during 2001-2012. The mean number of cataract, strabismus, cornea, glaucoma, and retina surgeries performed annually were 41526, 2626, 2381, 1096, and 5503, respectively. From 2001 to 2012, the proportion of cataract surgeries performed at ASCs increased 59% (from 43.7% to 69.7%), the proportion of strabismus surgeries performed at ASCs increased 153% (from 15.2% to 38.5%), the proportion of cornea surgeries performed at ASCs increased 55% (from 27.4% to 42.4%), the proportion of glaucoma surgeries performed at ASCs increased 32% (from 43.1% to 56.8%), and the proportion of retina surgeries performed at ASCs increased by nearly 2 fold (from 14.0% to 41.7%).

Conclusions : Over the past decade the proportion of ophthalmic surgeries performed at ASCs has increased substantially. Over two thirds of cataract surgeries are now performed at ASCs and surgeons are increasingly using ASCs for subspecialty ophthalmic surgeries as well. Future analyses need to explore the impact of this shift in care on patient outcomes, patient satisfaction, and costs.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

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