THE IMPACT OF SHORT PROCEDURE UNITS ON THE LOCUS, VOLUME AND COMPLEXITY OF ALL SURGICAL PROCEDURES : PENNSYLVANIA, 1974-1982.

Format:

Book

Thesis/Dissertation

Author/Creator:

KITZ, DEBORAH SUSAN.

Contributor:

University of Pennsylvania.

Subjects (All):

Medicine.

0564.

Local Subjects:

0564.

Physical Description:

233 pages

Contained In:

Dissertation Abstracts International 44-12B.

System Details:

Mode of access: World Wide Web.

text file

Summary:

Based on information about the safety and estimated savings from ambulatory surgery, several large third party payers have developed policies to encourage the development and increased use of ambulatory surgical facilities. The goal of these policies was to transfer operations from inpatient units to ambulatory units. To date, data only are available regarding specific operations; no data are available regarding the impact of the policies on all operations.

This project was designed to determine the impact of short procedure units (SPUs) on the locus, volume and complexity of all operations. Data for this project included information on claims for surgical services filed with Pennsylvania Blue Shield from 1974-1982. Data on operations performed in inpatient units, SPUs and providers' offices were examined.

Results of the analyses suggest that for all operations, for operations performed in different hospital-areas and for all provider specialties except dentistry, SPUs added to the total volume of operations and had little impact on the complexity of operations. Between 1974 and 1982, total surgical volume increased by 97%, inpatient volume increased 67%, SPU volume increased 247% and office volume increased 104%. The largest growth in SPU volume occurred in 1974-1975, but there was no moderation of the increase in inpatient or office volume during this time. The average complexity of inpatient operations was 7.2 CRV units., 2.6 CRV units for SPUs and 0.8 CRV units for offices. Among dentists for the period 1974-1982, there was a decline in inpatient volume of 61%, an increase of over 1000% in SPU volume and office volume was stable. In general, the results of this study suggest that SPUs served as an add-on site for care. Overall, operations were not transferred from inpatient units to SPUs.

Third party payers and health care policy makers and planners should be cautious about policies that encourage the use of SPUs without monitoring the overall impact of these policies. However, carefully designed certificate of need, peer review, utilization review and financial incentive programs may be implemented to realize the potential savings from the transfer of operations from inpatient units to SPUs.

Notes:

Source: Dissertation Abstracts International, Volume: 44-12, Section: B, page: 3716.

Thesis (Ph.D.)--University of Pennsylvania, 1983.

Local Notes:

School code: 0175.

Access Restriction:

Restricted for use by site license.