Quality of care in accredited and nonaccredited ambulatory surgical centers

Nir Menachemi, Askar Chukmaitov, Steven L. Brown, Charles Saunders, Robert G. Brooks

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Little is known about quality outcomes in accredited and nonaccredited ambulatory surgical centers (ASCs). Quality outcomes in ASCs accredited by either the Accreditation Association for Ambulatory Health Care (AAAHC) or The Joint Commission were compared with those of nonaccredited ASCs in Florida. Methods: Patient-level ambulatory surgery and hospital discharge data from Florida for 2004 were merged and analyzed. Multivariate logistic regressions were estimated separately for the five most common ambulatory surgical procedures: colonoscopy, cataract removal, upper gastroendoscopy, arthroscopy, and prostate biopsy. Statistical models examined differences in risk-adjusted 7-day and 30-day unexpected hospitalizations between nationally accredited and nonaccredited ASCs. In addition to risk adjustment, each model controlled for facility volume of procedure and patient demographic characteristics including gender, race, age, and insurance type. Results: In multivariate analyses that controlled for facility volume and patient characteristics, patients at Joint Commission-accredited facilities were still significantly less likely to be hospitalized after colonoscopy. Specifically, compared with patients treated in nonaccredited ASCs regulated by the state agency, patients treated at those facilities were 10.9% less likely to be hospitalized within 7 days (adjusted odds ratio [OR] = 0.891; 95% confidence interval [C.I.], 0.799-0.993) and 9.4% less likely to be hospitalized within 30 days (adjusted OR = 0.906; 95% C.I., 0.850-0.966). No other differences in unexpected hospitalization rates were detected in the other procedures examined. Discussion: With the exception of one procedure, systematic differences in quality of care do not exist between ASCs that are accredited by AAAHC, those accredited by the Joint Commission, or those not accredited in Florida.

Original languageEnglish (US)
Pages (from-to)546-551
Number of pages6
JournalJoint Commission Journal on Quality and Patient Safety
Volume34
Issue number9
DOIs
StatePublished - Jan 1 2008
Externally publishedYes

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Quality of Health Care
Joints
Accreditation
Colonoscopy
Ambulatory Care
Ambulatory Surgical Procedures
Hospitalization
Odds Ratio
Confidence Intervals
Delivery of Health Care
Risk Adjustment
Arthroscopy
Statistical Models
Insurance
Cataract
Prostate
Multivariate Analysis
Logistic Models
Demography
Biopsy

ASJC Scopus subject areas

  • Leadership and Management

Cite this

Quality of care in accredited and nonaccredited ambulatory surgical centers. / Menachemi, Nir; Chukmaitov, Askar; Brown, Steven L.; Saunders, Charles; Brooks, Robert G.

In: Joint Commission Journal on Quality and Patient Safety, Vol. 34, No. 9, 01.01.2008, p. 546-551.

Research output: Contribution to journalArticle

Menachemi, Nir ; Chukmaitov, Askar ; Brown, Steven L. ; Saunders, Charles ; Brooks, Robert G. / Quality of care in accredited and nonaccredited ambulatory surgical centers. In: Joint Commission Journal on Quality and Patient Safety. 2008 ; Vol. 34, No. 9. pp. 546-551.
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