Safety and Quality of Joint Replacement Surgery Performed in Ambulatory Surgical Centers

The purpose of this study was to assist the Ambulatory Surgery Center Association (ASCA) in developing the evidence base to support Medicare coverage of select procedures in ambulatory surgery centers (ASCs).  Specifically, we collected and analyzed outcomes data for joint replacement surgeries (i.e., knee, hip, and shoulder) performed in ASCs and benchmarked these outcomes against national standards, where available.  To facilitate ASC self-reporting, KNG Health worked with our partner, Vindicet, to develop the Insight Data ToolTM, a secure on-line data collection tool that allows ASCs to safely relay relevant patient, quality, and outcomes data for analysis.  The tool was structured around five assessment modules: Pre-Op Assessment; Discharge Assessment; 30-day Post-Op Assessment; Patient Satisfaction Assessment; 180-day Post-Op Assessment.

We found low rates of complications or adverse outcomes among our sample of patients receiving joint replacement surgery in an ASC.   When benchmarked against existing safety measures for ASCs and other settings, we observe better performance among the ASCs in our sample as compared to others.  Our results suggest that joint replacement surgery in an ASC may be safe.  Our study has 2 primary limitations, when considering the applicability of our findings.  First, our sample size was small and only 3 ASCs participated in the study.  Thus, our estimates of complication rates may not be precise and may not be generalizable to other ASCs.  Second, we relied on self-reported information from the ASCs, including for information on hospital admissions and ED visits.

Services : Payment Policy & Delivery System Innovation, Quality & Performance Measurement Expertise: ,