scholarly journals Trends in Use of Ambulatory Surgery Centers for Cataract Surgery in the United States, 2001-2014

2018 ◽  
Vol 136 (1) ◽  
pp. 53 ◽  
Author(s):  
Brian C. Stagg ◽  
Nidhi Talwar ◽  
Cynthia Mattox ◽  
Paul P. Lee ◽  
Joshua D. Stein
2014 ◽  
Vol 120 (6) ◽  
pp. 1333-1338 ◽  
Author(s):  
Taiwo Aderibigbe ◽  
Barbara H. Lang ◽  
Henry Rosenberg ◽  
Qixuan Chen ◽  
Guohua Li

Abstract Background: Malignant hyperthermia (MH) is a rare hypermetabolic syndrome of the skeletal muscle and a potentially fatal complication of general anesthesia. Dantrolene is currently the only specific treatment for MH. The Malignant Hyperthermia Association of the United States has issued guidelines recommending that 36 vials (20 mg per vial) of dantrolene remain in stock at every surgery center. However, the cost of stocking dantrolene in ambulatory surgery centers has been a concern. The purpose of this analysis is to assess the cost-effectiveness of stocking dantrolene in ambulatory surgery centers as recommended by the Malignant Hyperthermia Association of the United States. Methods: A decision tree model was used to compare treatment with dantrolene to a supportive care-only strategy. Model assumptions include the incidence of MH, MH case fatality with dantrolene treatment and with supportive care-only. Sensitivity analyses were performed to assess the robustness of the estimated cost-effectiveness. Results: The estimated annual number of MH events in ambulatory surgery centers in the United States was 47. The incremental effectiveness of dantrolene compared with supportive care was 33 more lives saved per year. The incremental cost-effectiveness ratio was $196,320 (in 2010 dollars) per life saved compared with a supportive care strategy. Sensitivity analysis showed that the results were robust for the plausible range of all variables and assumptions tested. Conclusion: The results of this analysis suggest that stocking dantrolene for the treatment of MH in ambulatory surgery centers as recommended by the Malignant Hyperthermia Association of the United States is cost-effective when compared with the estimated values of statistical life used by U.S. regulatory agencies.


2019 ◽  
Vol 161 (4) ◽  
pp. 699-704 ◽  
Author(s):  
Yann-Fuu Kou ◽  
Ron B. Mitchell ◽  
Romaine F. Johnson

ObjectivesTo report nationwide estimates of ambulatory tonsillectomies performed in hospitals and ambulatory surgery centers in the United States.Study DesignCross-sectional survey.SettingNational databases.Subjects and MethodsWe analyzed the 2010 National Hospital Ambulatory Medical Care Survey of hospitals and ambulatory surgery centers for pediatric patients undergoing tonsillectomy with or without adenoidectomy. We determined estimations of the number of procedures, demographics, and outcomes. A tonsillectomy cohort from the 2009 National Inpatient Sample served as a comparison group.ResultsIn 2010, there were an estimated 339,000 (95% CI, 288,000-391,000) ambulatory tonsillectomies in the United States. The mean age was 7.8 years (SD, 5.1), and 71,000 (21.0%) were <3 years old. The male:female ratio was even (51% vs 49%). The racial makeup mirrored the US census (69% white, 18% Hispanic, and 12% black). Obstructive sleep-disordered breathing was reported in 48%. Perioperative events such as apnea, hypoxia, or bleeding occurred 7.8% of the time. Approximately 9% of patients could not be discharged home. When compared with cases of inpatient tonsillectomies, ambulatory cases comprised older patients (7.8 vs 5.9 years, P < .001) and were less likely to include obstructive sleep-disordered breathing (48% vs 77%, P < .001).ConclusionTonsillectomy was one of the most common ambulatory surgical procedures in 2010 in the United States. The majority of patients were low risk, but some at higher risk were included (age ≤3 years and obstructive sleep apnea). The National Hospital Ambulatory Medical Care Survey estimates provide useful baseline data for future research on quality measures and outcomes.


Surgery ◽  
2021 ◽  
Author(s):  
Randi S. Cartmill ◽  
Dou-Yan Yang ◽  
Benjamin J. Walker ◽  
Yasmin S. Bradfield ◽  
Tony L. Kille ◽  
...  

2019 ◽  
pp. 30-39
Author(s):  
Lynette Hathaway ◽  
Shawn Kepner ◽  
Rebecca Jones

Infectious endophthalmitis is a severe eye infection that can occur following cataract surgery. In this study, we sought to explore post-cataract infectious endophthalmitis events reported by ambulatory surgery centers (ASCs) in Pennsylvania. We queried the Pennsylvania Patient Safety Reporting System (PA-PSRS) database for post-cataract endophthalmitis events that occurred between 2009 and 2018. In the 10 calendar years analyzed, we identified 174 reports of post-cataract endophthalmitis, with rates per 1000 cataract procedures ranging from 0.05 in 2009 to 0.19 in 2018. The vast majority of these events were classified as serious (93%; n = 162 of 174), reflecting harm to patients, with one resulting in enucleation (the need to remove the affected eye). Healthcare staff and all involved stakeholders should act now by identifying sources of potential perioperative contamination, adhering to evidence-based infection prevention practices, and prioritizing areas of opportunity for improvement.


1983 ◽  
Vol 96 (3) ◽  
pp. 304-310 ◽  
Author(s):  
Walter J. Stark ◽  
M. Cristina Leske ◽  
David M. Worthen ◽  
George C. Murray

2012 ◽  
Vol 38 (4) ◽  
pp. 705-709 ◽  
Author(s):  
Paul B. Greenberg ◽  
Annika Havnaer ◽  
Thomas A. Oetting ◽  
Francisco J. Garcia-Ferrer

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