Because many of the high-volume procedures at ambulatory surgery centers are procedures that seniors undergo, outpatient centers that perform them should be fully prepared for the medical needs of the elderly, according to the Ambulatory Surgery Center Association.
A recent study on outpatient surgery care in the journal Surgery found that of the nearly 4 million patients who were sent home after having a procedure in three states between July 2008 and September 2009, about 3.2% were admitted to the hospital or visited a hospital emergency department within seven days of being discharged. The rate varied sharply by type of procedure, with diagnostic cardiac catheterization showing a particularly high rate. About half of the total population of patients studied were 60 and older, with 22% 60 to 69, 18% 70 to 79, and 10% 80 or older.
Experts say the keys to safety are thoughtful assessment of risks and benefits to outpatient surgery patients, and ensuring that the right clinical staffers are present when the procedure is performed. If anesthesia is involved, it's critical to know as much about the patient's medical history as possible, including their medications, said Dr. Jane Fitch, president of the American Society of Anesthesiologists.
Some worry that is not always happening. “Some centers might be pushing the envelope a bit,” Federico said. As ambulatory surgery centers expand their scope of procedures, clinicians may be performing tasks such as administering anesthesia or intubation without having specialized expertise. “They are trying to do more, and they are trying to do it at lower costs,” he said.
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