Fourth Quarter 2008, Volume 22, Number 4

Hospital, surgical center, office, does it matter?

IN THIS ISSUE

The increase in popularity of cosmetic surgery over the last decade

Laser surgery, treatment and options

Ask the Surgeon / Health Tip / What’s New

Hospital, surgical center, office, does it matter?

The location of your surgery is determined by your physician and depends on the type of procedure you have scheduled and what privileges the surgeon has with various facilities. It does matter where you have your surgery and you should be aware of the options and how you can ensure you are comfortable with your surgeon’s decision.

Before your procedure, confirm that the facility-hospital, outpatient center, or office-is accredited by one of the following organizations: the Accreditation Association for Ambulatory Health Care (AAAHC), 847-853-6060 or www.aaahc.org; the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), 888-545-5222 or www.aaaasf.org; the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), 630-792-5005 or www.jcaho.org; or licensed by the state in which the facility is located.

The accreditation process ensures that the facility is adequately equipped; meets fire, sanitation, and building codes; has been inspected and evaluated; and meets specific standards that assure patient safety and the efficiency of the facility and the equipment.

Hospital
A hospital setting provides a comprehensive range of health services. Most hospitals have in-patient and outpatient surgical facilities. If your procedure requires monitoring over night or an extended recovery, a hospital can accommodate your stay. In case of an emergency or a complication, you would have access to necessary medical staff and advanced medical equipment and technology.

Outpatient center
An ambulatory surgery center (ACS), or outpatient surgical center, specializes in providing same-day procedures that are more intensive than those done in the doctor’s office, but not as extensive as to require a hospital stay. Compared to a hospital stay, the outpatient environment may feel more tranquil and personal; the out-of-pocket expenses are also less.

In a study by the University of Pennsylvania, researchers identified risk factors that may increase hospital admission after an outpatient procedure: patient 65 years or older, operating time longer than two hours, cardiac diagnoses, peripheral vascular disease, cerebrovascular disease, malignancy, human immunodeficiency virus, and regional or general anesthesia. The report concluded that when surgeons are determining an appropriate surgical setting, whether in a hospital, outpatient center, or office, these factors should be considered.

Office setting
Procedures are typically 30 to 40 percent cheaper in an office setting versus a hospital or outpatient surgery center. Most importantly, you want to ensure that the office has been accredited. Factors that will determine if your surgery can be performed in the office safely are the extent of sedation (anesthesia), the length of the surgery, and if the office is equipped for the procedure. Discuss your options with your facial plastic surgeon. All experts agree that patients need to feel safe and overall to be safe.!