title: Establishment of a varicose vein center in a tertiary vascular surgery practice: urban versus rural differences.
abstract: We examined changes in practice patterns after the establishment of a varicose vein center (VVC) within two tertiary university vascular surgery practices and compared differences between urban (U) and rural (R) sites. Practice patterns for the treatment of VVs were compared 3 years before (period 1) and 3 years after (period 2) the formation of a U-VVC and an R-VVC in 2001. Both VVCs were part of similar-sized tertiary vascular surgery practices. Evaluation was specific to VVs, reticular veins, and telangiectasias. Prior to U-VVC, there were 338 office visits, six office procedures, and 114 hospital procedures. After U-VVC, there were 624, 120, and 312, respectively. Prior to R-VVC, there were 85 office visits, five office procedures, and 69 hospital procedures. After R-VVC, there were 528, 163, and 303, respectively. In period 1 for U-VVC and R-VVC, VVC relative value unit (RVU) generation as a percent of total practice RVUs was 1.0% and 0.7%, respectively. In period 2 for U-VVC and R-VVC, VVC RVU generation as a percent of total practice RVUs was 2.6% and 2.5%, respectively. In an effort to provide more coordinated treatment for patients with VVs, establishing a VVC within a tertiary academic vascular surgery practice can lead to rapid expansion of clinical volume by increased office visits, office procedures, and hospital procedures. Clinical demand for evaluation and treatment of VVs showed little variation between R-VVC and U-VVC.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Southern Illinois University, School of Medicine, Springfield, IL 62794-9638, USA.
authors.forename: Syed M
authors.initials: SM
authors.lastname: Hussain
authors.forename: Robert B
authors.initials: RB
authors.lastname: McLafferty
authors.forename: Marc A
authors.initials: MA
authors.lastname: Passman
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Datillo
authors.forename: Don E
authors.initials: DE
authors.lastname: Ramsey
authors.forename: Raoul J
authors.initials: RJ
authors.lastname: Guzman
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Naslund
authors.forename: Kim J
authors.initials: KJ
authors.lastname: Hodgson
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D006780:Hospitals, Rural / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D007087:Illinois; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013531:Surgicenters / Q000706:statistics & numerical data*; D013714:Tennessee; D014600:Utilization Review; D014648:Varicose Veins / Q000453:epidemiology / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data*