University of Utah, United States of America.
Division of Management Consulting, Department of Anesthesia, University of Iowa, 200 Hawkins Drive, 6-JCP, Iowa City, IA 52242, United States of America.
J Clin Anesth. 2018 Sep;49:88-91. doi: 10.1016/j.jclinane.2018.06.021. Epub 2018 Jun 15.
The US Agency for Healthcare Research and Quality's State Ambulatory Surgery Database includes procedures performed at hospital outpatient surgery departments. We hypothesized that, among US hospitals with an anesthesia department and freestanding outpatient surgical center, the prevalence on hospital campuses (i.e., within 250 yards of the main hospital building) would be sufficiently large (e.g., >10%) to influence interpretation of observational studies performed with US national ambulatory surgery datasets.
Randomly selected Medicare certified hospitals in the USA surveyed during a two-week period in February 2017.
Observational cohort study of 500 unique hospitals.
Freestanding surgery centers were obtained from a review of the websites of the hospitals. Google map street view was used to measure linear distances of the closest hospital-affiliated ambulatory surgery center with anesthesia provider(s) to each hospital's main building.
There were 124 hospitals with the website listing an affiliated ambulatory surgery center within 10 miles of the main campus. Of the 124 facilities, 53 were freestanding. Of the 53, there were 22 (42%) located within 250 yards, 95% confidence interval 29.1% to 55.9%, P < 0.0001 versus 10%.
The percentage of freestanding surgery centers located within 250 yards of main hospital buildings is sufficiently large to influence analyses. When using US national data, ambulatory surgery reported as performed at a hospital should not be considered as having been performed within the hospital. Similarly, hospital affiliated freestanding surgery centers should not be assumed to be more than a 5 min walk for anesthesia and operating room personnel from the hospital.
美国医疗保健研究与质量局的州门诊手术数据库包含在医院门诊外科部门进行的手术。我们假设，在美国拥有麻醉部门和独立门诊手术中心的医院中，医院校园内（即距离主医院大楼 250 码内）的患病率足够大（例如，>10%），足以影响使用美国国家门诊手术数据集进行的观察性研究的解释。
在 2017 年 2 月的两周内随机选择美国的医疗保险认证医院进行调查。
对 500 家独特医院进行观察性队列研究。
从医院网站的审查中获得独立的手术中心。谷歌地图街景用于测量最近的医院附属麻醉提供者的门诊手术中心与每个医院主建筑之间的最短直线距离。
有 124 家医院在其网站上列出了一个附属的门诊手术中心，距离主校区不到 10 英里。在这 124 家医院中，有 53 家是独立的。在这 53 家医院中，有 22 家（42%）位于 250 码内，95%置信区间 29.1%至 55.9%，P<0.0001 与 10%相比。
位于主医院大楼 250 码内的独立手术中心的百分比足够大，足以影响分析。当使用美国国家数据时，报告在医院进行的门诊手术不应被视为在医院内进行。同样，不应假设医院附属的独立手术中心距离医院麻醉和手术室人员的距离超过 5 分钟步行路程。
