Grants We Funded

Abstract

Project Summary: Ambulatory surgery centers (ASCs) are now the most common setting for procedural care in the United States, particularly for plastic surgery patients. Today, over 70% of surgical care is performed at ASCs. This trend continues to gain momentum. Previously, most ASCs were physician owned. Large healthcare systems are now acquiring and/or building ASCs to offset losses from other departments. Widespread ASCs are beneficial for patients as well. For example, not requiring support from a large hospital may improve access for those living in rural settings. Additionally, given the efficiency by which ASCs are run, these facility types are a driver of reduced healthcare spending. However, conclusions on the benefit of transition toward ASC practice are not well validated, as a growing body of research is needed to better define how such a shift in practice patterns have influenced the landscape of surgical care. The theme of this project is to better quantify how a shift toward outpatient surgical care has influenced racial, ethnic, and economic disparities in access to surgical care by three main outcome measures: (1) access (2) total cost, and (3) unexpected postoperative visits. Findings from our proposed work are aimed at two audiences. First, it will enable physicians to better counsel the patients, particularly when considering operative settings. Second, the results will influence further policy related to efficient and widespread ASC use.

Impact Statement: Outpatient surgery is an essential part of contemporary plastic surgery practice. Overall, over 50-70% of cases are performed at ambulatory surgery centers (ASCs). Little is known about access and outcomes for surgical care at these facilities. Despite the rate at which surgeries are performed at ASCs, research and quality measures are extremely limited. Our proposed research will therefore influence ASC based practice through policy and guideline development. This work is innovative for several reasons, including application of novel statistical techniques. More importantly, this work will contribute to defining how ASCs are assessed pertaining to readmission measures.

Biography
Prior to completing an accelerated 6-year B.S./M.D. program, I developed an interest in clinical outcomes research, particularly relating to healthcare policy and guidelines. Earlier to this, I spent time in a translational research lab which resulted in several presentations and publications during my undergraduate education. I then began clinical training in the latter half of medical school, where I found my true passion for clinical research. This continued into intern year and residency, as my desire to perform impactful clinical research led me to both lead a project and undertake a key role with several others. During my first years of clinical residency training, I found that plastic surgery was my calling. This field is dynamic, rapidly evolving, and in need of high-quality clinical research. This need is strongest in the understudied realm of outpatient surgery. This realization, combined with my career goal of becoming a surgeon-scientist then led me to pursue the T32 Research Fellowship in Plastic Surgery at the University of Michigan. During these two dedicated research years, I have been keen to take advantage of any opportunities. One such opportunity was for additional health services research training through pursuit of a Master’s in Health and Healthcare Research, in affiliation with the National Clinician Scholars Program. Building this foundation will lead me to become a successful academic plastic surgeon.