Department of Dermatology, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1071 , USA.
J Dermatolog Treat. 2010 Mar;21(2):101-6. doi: 10.1080/09546630902936760.
Regulations that cause minor cutaneous procedures to be moved from the physician's office to an ambulatory surgery center (ASC) or hospital may have the potential to unnecessarily increase the costs of these procedures from the Medicare perspective.
To investigate whether minor cutaneous procedures that could reasonably be performed in the office are being done in more intense settings (ASCs or hospitals), who is performing these procedures in alternative settings, and the cost of higher intensity settings.
Medicare claims data on a number of minor cutaneous surgery procedures performed by various medical disciplines, the location in which the procedures were performed, and the ratio of minor procedures done in each surgical setting by specialty were obtained using the 1992-2000 Medicare Current Beneficiary Survey (MCBS). We used Medicare reimbursements as a measure of the cost of the procedure.
When compared by surgical setting, the mean charges for each minor cutaneous procedure were greatest when the procedure was performed in the hospital setting and least when performed in the office setting. Owing to surgical setting, dermatologists were the most cost-effective specialists for the performance of minor cutaneous procedures.
Regulations that discourage office-based surgery could significantly increase medical care costs.
导致将一些小型皮肤手术从医生办公室转移到门诊手术中心（ASC）或医院的法规可能会导致从医疗保险的角度来看，这些手术的成本不必要地增加。
调查是否有一些合理地在办公室进行的小型皮肤手术正在更密集的环境中进行（ASC 或医院），在替代环境中进行这些手术的人员是谁，以及高强度环境的成本是多少。
使用 1992-2000 年医疗保险当前受益人大调查（MCBS）获得了多项由各种医学专业进行的小型皮肤外科手术的医疗保险索赔数据，手术的进行地点以及每个手术环境下每个专业进行的小型手术的比例。我们使用医疗保险报销作为手术费用的衡量标准。
按手术环境进行比较时，在医院环境中进行手术时，每种小型皮肤手术的平均费用最高，而在办公室环境中进行手术时，费用最低。由于手术环境的原因，皮肤科医生是进行小型皮肤手术最具成本效益的专家。
鼓励基于办公室的手术的法规可能会显著增加医疗保健成本。
