{"title":"美国农村门诊外科机构:2010 - 2020年趋势","authors":"Vineeth Amba , Shawn Izadi , Tarun Ramesh , Hao Yu","doi":"10.1016/j.amjsurg.2025.116188","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The volume and proportion of surgeries occurring in outpatient settings has increased. However, the growth and distribution of outpatient surgical institutions, namely ambulatory surgery centers (ASCs) and hospital-based outpatient surgical departments (HOPDs), remains understudied in rural areas.</div></div><div><h3>Methods</h3><div>We used descriptive statistics and a multivariate logistic regression to assess the growth and distribution of ASCs and HOPDs in rural areas from 2010 to 2020, leveraging the Area Health Resources Files and American Community Survey.</div></div><div><h3>Results</h3><div>From 2010 to 2020, the number of ASCs in rural counties decreased by 4.9 % (410 vs. 390), and rural HOPDs decreased by 14.3 % (1400 vs. 1200). Completely rural counties were over five times likelier to lack both ASCs and HOPDs (AOR = 5.32; 95 % CI = [4.82–5.89]); p < 0.001).</div></div><div><h3>Conclusions</h3><div>Outpatient surgical institution access in rural America declined. Policymakers should protect rural HOPDs, promote the creation of ASCs in rural communities, and incentivize surgeons to enter rural practice.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"242 ","pages":"Article 116188"},"PeriodicalIF":2.7000,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outpatient surgical institutions in the rural United States: Trends from 2010 to 2020\",\"authors\":\"Vineeth Amba , Shawn Izadi , Tarun Ramesh , Hao Yu\",\"doi\":\"10.1016/j.amjsurg.2025.116188\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>The volume and proportion of surgeries occurring in outpatient settings has increased. However, the growth and distribution of outpatient surgical institutions, namely ambulatory surgery centers (ASCs) and hospital-based outpatient surgical departments (HOPDs), remains understudied in rural areas.</div></div><div><h3>Methods</h3><div>We used descriptive statistics and a multivariate logistic regression to assess the growth and distribution of ASCs and HOPDs in rural areas from 2010 to 2020, leveraging the Area Health Resources Files and American Community Survey.</div></div><div><h3>Results</h3><div>From 2010 to 2020, the number of ASCs in rural counties decreased by 4.9 % (410 vs. 390), and rural HOPDs decreased by 14.3 % (1400 vs. 1200). Completely rural counties were over five times likelier to lack both ASCs and HOPDs (AOR = 5.32; 95 % CI = [4.82–5.89]); p < 0.001).</div></div><div><h3>Conclusions</h3><div>Outpatient surgical institution access in rural America declined. Policymakers should protect rural HOPDs, promote the creation of ASCs in rural communities, and incentivize surgeons to enter rural practice.</div></div>\",\"PeriodicalId\":7771,\"journal\":{\"name\":\"American journal of surgery\",\"volume\":\"242 \",\"pages\":\"Article 116188\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-01-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0002961025000108\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002961025000108","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景:门诊手术的数量和比例有所增加。然而,农村地区的外科门诊机构,即流动外科中心(ASCs)和医院外科门诊(HOPDs)的增长和分布仍未得到充分研究。方法:利用地区卫生资源档案和美国社区调查,采用描述性统计和多元logistic回归分析2010 - 2020年农村地区ASCs和hopd的增长和分布情况。结果:2010 - 2020年,农村各县ASCs数量减少4.9%(410家比390家),农村hopd数量减少14.3%(1400家比1200家)。完全农村县同时缺乏asc和hopd的可能性超过5倍(AOR = 5.32;95% ci = [4.82-5.89]);p结论:美国农村的门诊手术机构使用率下降。政策制定者应保护农村hopd,促进农村社区ASCs的创建,并激励外科医生进入农村实践。
Outpatient surgical institutions in the rural United States: Trends from 2010 to 2020
Background
The volume and proportion of surgeries occurring in outpatient settings has increased. However, the growth and distribution of outpatient surgical institutions, namely ambulatory surgery centers (ASCs) and hospital-based outpatient surgical departments (HOPDs), remains understudied in rural areas.
Methods
We used descriptive statistics and a multivariate logistic regression to assess the growth and distribution of ASCs and HOPDs in rural areas from 2010 to 2020, leveraging the Area Health Resources Files and American Community Survey.
Results
From 2010 to 2020, the number of ASCs in rural counties decreased by 4.9 % (410 vs. 390), and rural HOPDs decreased by 14.3 % (1400 vs. 1200). Completely rural counties were over five times likelier to lack both ASCs and HOPDs (AOR = 5.32; 95 % CI = [4.82–5.89]); p < 0.001).
Conclusions
Outpatient surgical institution access in rural America declined. Policymakers should protect rural HOPDs, promote the creation of ASCs in rural communities, and incentivize surgeons to enter rural practice.
期刊介绍:
The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.