Are hospitals safer than ambulatory surgical centers?

The death of Joan Rivers has increased scrutiny of outpatient medical centers and ambulatory surgery centers (ASCs), according to PBS Newshour.

"It can be kind of tricky for patients to tell the difference between what is a hospital [and] what's an outpatient surgery center," Shannon Pettypiece of Bloomberg News told Newshour. ASCs differ from hospitals in that they typically do not have emergency rooms (ERs) or intensive care units and are usually owned by the physicians performing the procedures, Pettypiece said.

Two factors drive their proliferation: an increasing number of outpatient procedures and their cheaper prices due to lower overhead, according to Pettypiece. In addition, a study published in Health Affairs this year found the facilities are typically more efficient, taking about 32 fewer minutes per procedure on average than hospitals, FierceHealthcare previously reported.

Although no data indicate that outpatient clinics pose a greater risk than hospitals, Pettypiece said, because they lack ERs, if patients experience complications, the facilities must call 911 and transfer patients to a hospital ER. This means patient outcomes may tie to the ASC's proximity to a hospital.

When patients consider a procedure at an ASC, she said they should consider the distance of the facility from an ER and also whether the physician has an ownership stake in the business, which is a potential conflict of interest.

An opinion piece in the American Spectator also calls for outpatient surgical facilities to post a notice that indicates all of its doctors have admitting privileges to a nearby hospital, as required of abortion providers in a series of controversial recent state laws.

To learn more:
- watch the Newshour video
- read the American Spectator piece

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