Strategy, structure, and patient quality outcomes in ambulatory surgery centers (1997-2004).
The purpose of this study was to examine potential associations among ambulatory surgery centers' (ASCs) organizational strategy, structure, and quality performance. The authors obtained several large-scale, all-payer claims data sets for the 1997 to 2004 period. The authors operationalized quality performance as unplanned hospitalizations at 30 days after outpatient arthroscopy and colonoscopy procedures. The authors draw on related organizational theory, behavior, and health services research literatures to develop their conceptual framework and hypotheses and fitted fixed and random effects Poisson regression models with the count of unplanned hospitalizations. Consistent with the key hypotheses formulated, the findings suggest that higher levels of specialization and the volume of procedures may be associated with a decrease in unplanned hospitalizations at ASCs.
Chukmaitov
Askar
A
Department of Healthcare Policy and Research, Virginia Commonwealth University, School of Medicine, P.O. Box 980430, Richmond, VA 23298, USA. achukmaitov@vcu.edu
Devers
Kelly J
KJ
Harless
David W
DW
Menachemi
Nir
N
Brooks
Robert G
RG
D000556:Ambulatory Surgical Procedures / Q000592:standards*; D001182:Arthroscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D003113:Colonoscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D005431:Florida; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D020379:Risk Adjustment; D012720:Severity of Illness Index