Every year, 1.2 billion visits are made in ambulatory care settings, accounting for approximately one third of health care spending in the United States.1,2 Although the vast majority of these visits take place in office-based clinics and emergency departments, an increasing number of patients are seeking care in nontraditional sites such as retail clinics and urgent care centers. Retail clinic...

OBJECTIVE This report describes ambulatory visits for asthma in the United States across three ambulatory care settings. The primary focus is on visits to office-based physicians. METHODS The data sources include the National Ambulatory Medical Care Survey (NAMCS), a national probability survey of visits to office-based physicians in the United States, and the National Hospital Ambulatory Med...

Data and financial models based on an operational health information exchange suggest that health care delivery costs can be reduced by making clinical data available at the time of care in urban emergency departments. Reductions are the result of decreases in laboratory and radiographic tests, fewer admissions for observation, and lower overall emergency department costs. The likelihood of red...

This article explores whether Medicare pays more for the same outpatient services provided in an acute specialty hospital than in an ambulatory surgery center (ASC). How financially dependent a specialty hospital is on ASC-eligible services is also investigated. Medicare outpatient claims in 43 orthopedic and 12 surgical specialty hospitals in 2004 were repriced using ASC pricing software. Paym...

The nation has been on a quest to advance quality in providing health care services and improving patient outcomes. The challenge has been to identify and define metrics that will demonstrate improvement. Acute care settings have a fairly well-established system of quality measurement, but ambulatory care systems are in less-developed stages. Imperative to accurate quality measurement in ambula...

Increasing student numbers and changes in healthcare delivery are making inpatient settings less ideal for teaching undergraduate students. As the focus of healthcare provision shifts towards ambulatory care, increasing attention must now be given to developing opportunities for clinical teaching in this setting. This Education Guide describes the opportunities to be made available by introduci...

The majority of patient safety and quality research has focused on the inpatient setting, leaving a lack of intervention-based research in patient safety and quality for the ambulatory setting. There were an estimated 1.1 billion ambulatory visits in the US in 2010 with this number expecting to rise due to the shift from inpatient to outpatient care and the aging population. Given these numbers...

nursing time required to care for patients. However, time is not the only factor to consider when measuring nursing workload, a prerequisite for developing ambulatory care nurse staffing models. For this reason , when nurses, managers, and administrators ask about the method for determining the levels and numbers of nursing staff appropriate for delivering quality care in the ambulatory setting...

T hefirst ambulatory surgery center was established in 1970 in Phoenix, Arizona by two surgeons with a vision of providing more convenient surgical services to their community. Twelve years later, Medicare approved the first payments to ambulatory surgery centers, sparking an era of substantial growth. By 1988, there were 1000 ambulatory surgery centers in the United States, and today more than...