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36 OUTPATIENT SURGERY Here are the top 26 outpatient procedures – No. 1 topped the list by a landslide By Angie Stewart P hysicians performed nearly 113 million routine venipunctures in 2016, making that the most popular outpatient procedure that year, according to Definitive Healthcare data from Medicare claims. Routine venipunctures were performed over 47 times more frequently than the next most common outpatient procedure, esophageal biopsy. Physicians provided about three times more outpatient procedures than inpatient proce- dures in 2016. More than 184 million outpa- tient procedures took place, compared to 58 million inpatient surgical procedures. Here are the top 26 outpatient procedures by volume: 1. Routine venipunctures: More than 113,000,000 2. Esophagogastroduodenoscopy biopsy: 2,442,826 3. Capillary blood draw: 2,338,560 4. Colonoscopy and biopsy: 2,210,609 5. Debridement of subcutaneous tissue 20 sq. cm. or less: 1,924,540 6. Draw blood off venous device: 1,591,989 7. Repair superficial wounds: skin, neck, gen- itals, trunk (2.5 sq. cm. or less): 1,471,470 8. Colonoscopy with lesion removal: 1,393,577 9. Drain or inject fluid, major joint: 1,263,331 10. Diagnostic colonoscopy: 1,234,234 11. Blood transfusion service: 1,213,099 12. Apply forearm splint: 955,845 13. Cataract surgery with intraocular implant 1 stage: 955,403 14. Repair superficial wounds — face, ears, eyelids, nose, lips, mucus membrane (2.5 sq. cm. or less): 890,188 15. Repair superficial wounds — skin, neck, genitals, trunk (2.6 to 7.5 sq. cm.): 881,517 16. Drainage of skin abscess: 827,510 17. Collect blood from PICC: 793,509 18. Injection into lumbar/sacral spine: 765,314 19. Place needle in vein: 718,901 20. Withdrawal of arterial blood: 671,543 21. Application of lower leg splint: 592,942 22. Apply multilayer compression system to lower leg: 582,867 23. Insert temporary bladder catheter: 562,176 24. Injection of anaesthetic and/or steroid into lumbar/sacral spine: 549,535 25. Diagnostic esophagogastroduodenoscopy via brushing or washing: 469,601 26. Laparoscopic cholecystectomy: 460,025 n Study finds fewer adverse events after treatment at ASCs vs. HOPDs — 6 takeaways By Angie Stewart P atients treated in an ambulatory surgery center are less likely to be admitted to a hospital or visit an emergency room in a short period after outpatient surgery, according to an independent study published in the Journal of Health Economics. The study compared ASCs and HOPDs on two quality of care measures: inpatient admission and ER visits on the same day, seven or 30 days after an outpatient procedure. Here are six takeaways: 1. The study focused on physicians who operate in both ASCs and HOPDs and analyzed the 10 most common pro- cedures by ASC volume in 2007. 2. Researchers examined variation in Medicare facility pay- ments to estimate how treatment setting impacted patient outcomes. This methodology was used to ensure results showed differences in quality of care rather than differenc- es in patient health. 3. As predicted ASC payment rates increase, patients are more likely to be treated in an ASC, the study found. 4. Researchers concluded ASC treatment reduces the probability of same day, seven-day and 30-day inpatient admissions and ER visits relative to HOPDs. 5. The study determined the rate of post-procedure ad- verse events decreased for both low and high-risk patients. 6. Researchers found evidence that ASC treatment may re- duce medical complications and ER visits. They found no evidence of a statistically significant relationship between ASC treatment and ER visits for infections. "The findings in this paper indicate that ASCs provide high quality services and suggest that promoting greater use of ASCs may lead to healthcare cost savings and overall wel- fare gains," the authors said. n