Trong số các bác sĩ phẫu thuật chỉnh hình, sự phổ biến của phẫu thuật ngoại trú tại văn phòng đã tăng lên đều đặn. Thay đổi mô hình thực hành, bao gồm các trung tâm phẫu thuật Sử dụng văn phòng, có cải tiến hiệu quả và kết quả lại tăng lên. Tuy nhiên, khả thi và tính chính xác thị trường phân tích chính xác là cần thiết | Perspectives on Modern Orthopaedics Office Ambulatory Surgery Centers Creation and Management Neal C. Small MD and Jack M. Bert MD Abstract Among orthopaedic surgeons the popularity of in-office ambulatory surgery has steadily increased. Changing practice patterns including utilization of oữce surgery centers have resulted in improved efficiency and increased revenue. However accurate feasibility and market analyses are necessary before considering the addition of a surgery center to an orthopaedic practice. The legal requirements to operate a center include state licensure Medicare certi cation and accreditation. In addition approved construction design and effective operations management are essential. J Am Acad Orthop Surg 2003 11 157-162 Since the introduction of arthroscopy to North America in 1965 the development of minimally invasive orthopaedic surgical techniques has steadily As a result beginning in the 1980s 2 some orthopaedic procedures were moved from the hospital environment to the freestanding ambulatory surgery center and more recently to the orthopaedic office ambulatory surgery center OASC . Early concern for patient safety led to preoperative evaluation intraoperative monitoring and postoperative care being designed into the 4 The cost-effectiveness of OASCs soon became evident to third-party payers as well as to surgeons and patients. Payers became less reluctant to preauthorize surgery in the office environment once the issues of facility charges and patient safety were addressed to their satisfaction. The emphasis on cost containment which heightened in the early 1990s accelerated the development of OASCs in the mid to late However without state licensure Medicare certi cation and accreditation anesthesia restrictions limited the types of procedures that could be done in an office operatory. General anesthesia could not be administered in a nonlicensed facility and even when local anesthesia or monitored .
