Ambulatory surgery center

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An ambulatory surgery center can also known as outpatient surgery centers or same day surgery centers.

An ambulatory surgery center (ASC) is a health care facility that specializes in providing surgery, pain management and certain diagnostic (e.g., colonoscopy) services in an outpatient setting. Overall, the services provided can be generally called procedures. In simple terms ASC qualified procedures can be considered procedures that are more intensive than that done in the average doctors office but not so intensive as to require an hospital stay after the procedure. An ambulatory surgery center and a specialty hospital often provide similar facilities and support similar type of procedures. The specialty hospital may provide the same procedures or slightly more complex procedures and the specialty hospital will often provide overnight stays for patients. Ambulatory surgery centers do not provide emergency services.

'Procedures' performed in surgery centers have a considerably range in scope and type of procedure. In the 1980s and 1990s many procedures that used to be proformed exclusively in hospitals began to also be performed in ambulatory surgery centers. Many knee, shoulder, eye surgeries and other surgeries are now performed in ambulatory surgery centers. Some heart procedures are even performed in ambulatory surgery centers. In the USA today over 50% of Colonoscopy services are performed in ambulatory surgery centers.

The first ASC was established in Phoenix, Arizona in 1970 by two physicians who wanted to provide timely, convenient and comfortable surgical services to patients in their community.

Ambulatory surgery centers rarely have a single owner. Physicians who perform surgeries in the center will often own a small part of the center (a 1% or less ownership might be common, but percentages can vary considerable). Physicians may occasionally own all of the surgery center however it is very common to have a corporation own a percentage of the ambulatory surgery center as well. Physicians as a group or the corporation either may own the majority of the ambulatory surgery center. A number of corporations own and run a group of surgery centers.

Some large healthcare companies own many type of medical facilities including ambulatory surgery centers. The largest operator is HealthSouth Corporation at about 175 centers. Other examples of these larger companies include HCA at about 95 centers. Although HealthSouth has announce they are either going to sell or spin-off their ambulatory surgery center division. There are also companies that specialize and only own ambulatory surgery centers such as Amsurg.

In the United States, over six million surgeries a year are performed in approximately 3,300 ASCs. There are ASCs in all 50 states and throughout the world. In the U.S., most ASCs are licensed, certifed by Medicare and accredited by one of the major health care accrediting organizations.

Although complications are very rare, ASCs are required by Medicare and the accreditation organizations to have a backup plan for transfer of patients to a hospital if the need arises.

The trade organizations of ASCs include the Federated Ambulatory Surgery Association (FASA) and American Association of Ambulatory Surgery Centers (AAASC).

Accreditation organizations are separate from the general trade organizations. Accreditation organizations for ASCs provide standards of medical care, record keeping and audit ASCs. Some of the goals of these organizations include continuous improvement of medical care in surgery centers and providing an external organization the public can get information on overall operation of surgery centers. These accreditation organizations require members to receive periodic audits. These audits will come every one to three years depends on the accreditation organization and the circumstances of the surgery center. In an audit a team of auditor will come to the facility and examine the surgery centers medical records, written policies and compliance with industry standards.

In 1996, California was the first state to require accreditation for all outpatient facilities that administer sedation or general anesthesia. Many other states have followed and require accrediatation.

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