Strope Seth A, Sarma Aruna, Ye Zaojun, Wei John T, Hollenbeck Brent K
Department of Urology, Division of Health Services Research, University of Michigan Health System, Ann Arbor, MI, USA.
BMC Health Serv Res. 2009 Jul 21;9:121. doi: 10.1186/1472-6963-9-121.
Ambulatory surgical centers (ASCs) provide outpatient surgical services more efficiently than hospital outpatient departments, benefiting patients through lower co-payments and other expenses. We studied the influence of socioeconomic status and race on use of ASCs.
From the 2005 State Ambulatory Surgery Database for Florida, a cohort of discharges for urologic, ophthalmologic, gastrointestinal, and orthopedic procedures was created. Socioeconomic status was established at the zip code level. Logistic regression models were fit to assess associations between socioeconomic status and ASC use.
Compared to the lowest group, patients of higher socioeconomic status were more likely to have procedures performed in ASCs (OR 1.07 CI 1.05, 1.09). Overall, the middle socioeconomic status group was the most likely group to use the ASC (OR 1.23, CI 1.21 to 1.25). For whites and blacks, higher status is associated with increased ASC use, but for Hispanics this relationship was reversed (OR 0.84 CI 0.78, 0.91).
Patients of lower socioeconomic status treated with outpatient surgery are significantly less likely to have their procedures in ASCs, suggesting that less resourced patients are encountering higher cost burdens for care. Thus, the most economically vulnerable group is unnecessarily subject to higher charges for surgery.
门诊手术中心（ASC）比医院门诊部更高效地提供门诊手术服务，通过降低自付费用和其他费用使患者受益。我们研究了社会经济地位和种族对ASC使用情况的影响。
从2005年佛罗里达州门诊手术数据库中，创建了一组泌尿外科、眼科、胃肠科和骨科手术出院病例。社会经济地位在邮政编码级别确定。采用逻辑回归模型评估社会经济地位与ASC使用之间的关联。
与最低社会经济地位组相比，社会经济地位较高的患者更有可能在ASC进行手术（OR 1.07，CI 1.05，1.09）。总体而言，中等社会经济地位组是最有可能使用ASC的组（OR 1.23，CI 1.21至1.25）。对于白人和黑人，社会经济地位较高与ASC使用增加相关，但对于西班牙裔，这种关系则相反（OR 0.84，CI 0.78，0.91）。
接受门诊手术治疗的社会经济地位较低的患者在ASC进行手术的可能性显著降低，这表明资源较少的患者面临更高的护理成本负担。因此，经济上最脆弱的群体不必要地承受了更高的手术费用。
