Comparative outcomes analysis of procedures performed in physician offices and ambulatory surgery centers.
OBJECTIVE
This study compared outcomes to determine whether patient safety is similar in Florida ambulatory surgery centers and offices.


METHODS
All adverse incident reports to the Florida Board of Medicine for procedure dates April 1, 2000, to April 1, 2002 were reviewed. The numbers of office procedures performed during a 4-month period were used to estimate the total number of procedures. Ambulatory surgery death summaries, adverse incident data, and volumes of procedures for 2000 were procured from the Florida Agency for Health Care Administration.


METHODS
Adverse incident reports were reviewed by multiple parties; only reports that involved an office surgical procedure and resulted in injury or death were included in the outcomes calculation. Reports were extracted independently by multiple reviewers.


RESULTS
Adverse incidents occurred at a rate of 66 and 5.3 per 100,00 procedures in offices and ambulatory surgery centers, respectively. The death rate per 100,000 procedures performed was 9.2 in offices and 0.78 in ambulatory surgery centers. The relative risks for injuries and deaths for office procedures vs ambulatory surgery centers were 12.4 (95% confidence interval, 9.5-16.2) and 11.8 (95% confidence interval, 5.8-24.1), respectively.


CONCLUSIONS
In this review of surgical procedures performed in offices and ambulatory surgery centers in Florida during a recent 2-year period, there was an approximately 10-fold increased risk of adverse incidents and death in the office setting. If all office procedures had been performed in ambulatory surgery centers, approximately 43 injuries and 6 deaths per year could have been prevented.
Vila
Hector
H
Department of Anesthesiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA.
Soto
Roy
R
Cantor
Alan B
AB
Mackey
David
D
D000556:Ambulatory Surgical Procedures / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D002423:Cause of Death; D005431:Florida; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000331:legislation & jurisprudence; D010824:Physicians' Offices / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D013531:Surgicenters / Q000706:statistics & numerical data*