Featured Research

from universities, journals, and other organizations

Outpatient urological surgery costs significantly less when performed in physician offices and ambulatory care centers

Date:
October 22, 2012
Source:
Elsevier
Summary:
More and more outpatient surgical procedures are being done at nonhospital-based facilities such as freestanding ambulatory surgical centers and physician offices, instead of at hospital-based outpatient departments. A new study comparing the cost to Medicare of 22 urological surgical procedures performed in each setting has found that ambulatory surgery centers and physician offices are less costly than hospitals.

More and more outpatient surgical procedures are being done at nonhospital-based facilities such as freestanding ambulatory surgical centers and physician offices, instead of at hospital-based outpatient departments. A new study comparing the cost to Medicare of 22 urological surgical procedures performed in each setting has found that ambulatory surgery centers and physician offices are less costly than hospitals.

The results are published in the December issue of The Journal of Urology.

"Our findings indicate that for comparable procedures, hospitals were associated with significantly higher payments than ambulatory surgical centers and the physician office," says lead investigator John M. Hollingsworth, MD, Department of Urology, Dow Division of Health Services Research and Center for Healthcare Outcomes & Policy, University of Michigan, Ann Arbor. "In fact, offloading 50% of the procedures from hospitals to ambulatory surgery centers would save the Medicare program nearly $66 million annually."

Investigators examined national Medicare claims from 1998 to 2006, identifying elderly patients who underwent one of 22 common outpatient urological procedures. They measured all relevant payments made within 30 days of the procedure to capture any costs that may have resulted from postoperative complications and unexpected hospitalizations. They assessed the extent to which hospital payments, professional services, and facility payments vary by the ambulatory care setting where a procedure is performed.

The authors found that 88% of the procedures examined were performed at an ambulatory surgical center or physician office. Ambulatory surgical centers and physician offices were less costly than hospitals for all but two of the procedures. For instance, average adjusted total payments for urodynamic procedures performed at ambulatory surgical centers were less than a third of those done in hospitals. Compared to hospitals, office based prostate biopsies were nearly 75% less costly. While physician offices tended to be more cost-efficient than ambulatory surgical centers, the difference was not significant. Facility payments tended to be the driver of payment differences.

The average Charlson score, which measures how severely ill a patient is, was lower for patients treated in a nonhospital setting. Dr. Hollingsworth notes that low risk patients may be more likely to be treated in an ambulatory setting, and the results may reflect the lower cost of treating patients who are less seriously ill. While Medicare claims data may not be generalizable to other payers, Dr. Hollingsworth says, "the Medicare program accounts for 19% of total national spending on personal health services, making it the single largest payer in the United States. Therefore, with regard to health care financing, as Medicare goes, so goes the nation."

Dr. Hollingsworth and his colleagues observe that if the cost differences between nonhospital and hospital settings are unjustified, e.g., due to inefficiencies rather than case mix, service, or content, then Medicare might base payment in the future on costs at the least expensive setting. "Alternatively, Medicare may bundle reimbursements to facilities and physicians involved in care around a single outpatient surgical episode into a single payment. The observed variation in facilities payments suggests opportunities for improvement," they conclude.


Story Source:

The above story is based on materials provided by Elsevier. Note: Materials may be edited for content and length.


Journal Reference:

  1. John M. Hollingsworth, Chris S. Saigal, Julie C. Lai, Rodney L. Dunn, Seth A. Strope, Brent K Hollenbeck, and the Urologic Diseases in America project. Medicare Payments for Outpatient Urological Surgery by Location of Care. The Journal of Urology, 2012; 188 (6) DOI: 10.1016/j.juro.2012.08.031

Cite This Page:

Elsevier. "Outpatient urological surgery costs significantly less when performed in physician offices and ambulatory care centers." ScienceDaily. ScienceDaily, 22 October 2012. <www.sciencedaily.com/releases/2012/10/121022080612.htm>.
Elsevier. (2012, October 22). Outpatient urological surgery costs significantly less when performed in physician offices and ambulatory care centers. ScienceDaily. Retrieved August 29, 2014 from www.sciencedaily.com/releases/2012/10/121022080612.htm
Elsevier. "Outpatient urological surgery costs significantly less when performed in physician offices and ambulatory care centers." ScienceDaily. www.sciencedaily.com/releases/2012/10/121022080612.htm (accessed August 29, 2014).

Share This




More Health & Medicine News

Friday, August 29, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

3 Things To Know About The Ebola Outbreak's Progression

3 Things To Know About The Ebola Outbreak's Progression

Newsy (Aug. 29, 2014) Here are three things you need to know about the deadly Ebola outbreak's progression this week. Video provided by Newsy
Powered by NewsLook.com
Killer Amoeba Found in Louisiana Water System

Killer Amoeba Found in Louisiana Water System

AP (Aug. 28, 2014) State health officials say testing has confirmed the presence of a killer amoeba in a water system serving three St. John the Baptist Parish towns. (Aug. 28) Video provided by AP
Powered by NewsLook.com
Who Could Be Burnt by WHO's E-Cigs Move?

Who Could Be Burnt by WHO's E-Cigs Move?

Reuters - Business Video Online (Aug. 28, 2014) The World Health Organisation has called for the regulation of electronic cigarettes as both tobacco and medical products. Ciara Lee looks at the impact of the move on the tobacco industry. Video provided by Reuters
Powered by NewsLook.com
CDC Director On Ebola Outbreak: 'It's Worse Than I Feared'

CDC Director On Ebola Outbreak: 'It's Worse Than I Feared'

Newsy (Aug. 28, 2014) CDC director Tom Frieden says the Ebola outbreak is even worse than he feared. But he also said there's still hope to contain it. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins