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Ambulatory surgery centers (ASCs) are rapidly growing as a setting for the delivery of health care services, both in California and in the United States. At present, little is known about either the measurement of quality in the ASC setting or about the regulation of ASCs by the various U.S. state governments. This report describes the California ASC landscape, compares California ASCs to hospital outpatient surgery departments, and compares California's regulation of Ambulatory Surgery Centers to the regulations of other states. The research revealed differences in patterns of volume and procedure specialization between ASCs and hospital outpatient surgery departments. These differences could have implications for quality if high volume is associated with quality or if more specialization is associated with higher quality. However, there is little research on these questions for outpatient surgery at present.

Table of Contents

  • Chapter One

    Background and Introduction

  • Chapter Two

    California's Ambulatory Surgery Centers

  • Chapter Three

    A Comparison of ASC Regulation

  • Chapter Four

    Summary and Conclusions

  • Appendix A

    ASC Ownership Comparison

  • Appendix B

    Tabular State Regulation Data

  • Appendix C

    Top 100 Procedures for Either ASCs or Hospitals

  • Appendix D

    National Quality Forum ASC Performance Measures

This work was sponsored by the California HealthCare Foundation. The research was conducted in RAND Health, a division of the RAND Corporation.

This report is part of the RAND Corporation technical report series. RAND technical reports may include research findings on a specific topic that is limited in scope or intended for a narrow audience; present discussions of the methodology employed in research; provide literature reviews, survey instruments, modeling exercises, guidelines for practitioners and research professionals, and supporting documentation; or deliver preliminary findings. All RAND reports undergo rigorous peer review to ensure that they meet high standards for research quality and objectivity.

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