Page 15 - Layout 1

PEDIATRICS

ease of scheduling, ability to tailor a staff to meet the unique needs
of each type of surgery, tailor facilities/equipment to cater to the
needs of the surgical staff. In addition, 90% of ASCs are at least
partially owned by physicians.
The hope is that with the benefit of cost and convenience, quality
of care is not being compromised. On this front, the ASC commu-
nity has developed a quality initiative voluntarily to promote quality
and safety in ASCs. In addition, federal requirements govern ASCs
in order to participate in Medicare program (table 1). Based on these
interventions and the available data, there does not appear to be a
gap in the quality of care between hospital-based surgeries versus
ASCs in appropriately matched patient and operation (5).

Cons

While financial consideration makes ASCs very attractive, there
are limitations to consider.

Case Selection
As these centers are often not equipped with the facilities neces-
sary for on campus admissions and overnight observations, the
and ASA 3 or greater (representing significant comorbidity), recent scope of surgeries that are feasible are limited. Any operation that
upper respiratory illness. The surgical center is tasked with screening would require monitoring/observation for more than a few hours
children to deem whether or not he/she is an appropriate candidate after surgery are not appropriate for this setting.
for surgery in the ambulatory setting.
Patient Selection
Pros Appropriate patient selection is equally as important as case se-
Why even consider sending your child to an Ambulatory lection. Patients that fall into the category of ASA Physical Status
Surgical Center (ASC)? Classification III or higher should be cleared by an anesthesiologist
From the perspective
of the taxpayer and gov-
ernment entities con-
cerned with rising
healthcare costs, ASC’s
serve to decrease health
care expenditures. Based
on a 2013 analysis be-
tween 2008-2011 ASCs
saved Medicare $7.5 bil-
lion dollars (4). This cost
benefit is translated to
the patient in the form
of lower costs/copays.
From the physician
perspective, the benefits
of operating at an ASC
include more control
over surgical practices,

continued on page 16
visit us at www.bcms.org 15