National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (2)
- Adverse Drug Events (ADE) (1)
- Adverse Events (6)
- (-) Ambulatory Care and Surgery (36)
- Asthma (1)
- Behavioral Health (2)
- Blood Pressure (3)
- Cancer (1)
- Cardiovascular Conditions (1)
- Caregiving (1)
- Care Management (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (3)
- Chronic Conditions (2)
- Clinician-Patient Communication (1)
- Critical Care (1)
- Diabetes (1)
- Dialysis (1)
- Electronic Health Records (EHRs) (3)
- Emergency Medical Services (EMS) (3)
- Evidence-Based Practice (1)
- Eye Disease and Health (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (6)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (6)
- Health Insurance (1)
- Health Services Research (HSR) (1)
- Health Status (1)
- Heart Disease and Health (2)
- Hospitalization (3)
- Imaging (1)
- Injuries and Wounds (3)
- Inpatient Care (1)
- Kidney Disease and Health (2)
- Medical Errors (1)
- Medical Expenditure Panel Survey (MEPS) (3)
- Medical Liability (1)
- Medication (5)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Obesity: Weight Management (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Safety (8)
- Patient Self-Management (1)
- Payment (1)
- Policy (1)
- Practice Patterns (3)
- Pregnancy (1)
- Prevention (1)
- Primary Care (2)
- Provider (2)
- Provider: Pharmacist (1)
- Quality Improvement (2)
- Quality Measures (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (1)
- Risk (1)
- Surgery (8)
- Telehealth (1)
- Transitions of Care (1)
- Treatments (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 36 Research Studies DisplayedSteiner CA, Maggard-Gibbons M, Raetzman SO
Return to acute care following ambulatory surgery.
This study determined the rates of all-cause, unplanned revisits (i.e., not for routine medical care) within 30 days of ambulatory surgery and whether revisits were related to the operation. It found that acute care revisits following ambulatory operations in low-risk patients occurred with notable frequency across 6 diverse types of operations.
AHRQ-authored
Citation: Steiner CA, Maggard-Gibbons M, Raetzman SO .
Return to acute care following ambulatory surgery.
JAMA 2015 Oct 6;314(13):1397-9. doi: 10.1001/jama.2015.12210..
Keywords: Healthcare Cost and Utilization Project (HCUP), Ambulatory Care and Surgery, Surgery, Adverse Events
Hollenbeck BK, Dunn RL, Suskind AM
Ambulatory surgery centers and their intended effects on outpatient surgery.
Using a twenty percent national sample of Medicare beneficiaries, the researchers assessed the impact of ambulatory surgery centers (ASCs) on rates of hospital-based outpatient procedures and adverse events. They found that opening of an ambulatory surgery center in a Hospital Service Area resulted in a decline in hospital-based outpatient surgery without increasing mortality or admission.
AHRQ-funded; HS020927; HS018726.
Citation: Hollenbeck BK, Dunn RL, Suskind AM .
Ambulatory surgery centers and their intended effects on outpatient surgery.
Health Serv Res 2015 Oct;50(5):1491-507. doi: 10.1111/1475-6773.12278..
Keywords: Ambulatory Care and Surgery, Adverse Events, Patient Safety
Hurst DM, Oster ME, Smith S
Is clinic visit frequency associated with weight gain during the interstage period? A report from the Joint Council on Congenital Heart Disease National Pediatric Cardiology Quality Improvement Collaborative (JCCHD-NPCQIC).
The researchers sought to determine whether frequency of outpatient clinic visits correlated with weight gain in patients with hypoplastic left heart syndrome or variant during the interstage period between discharge from stage I palliation and presentation for stage II palliation . There was no correlation between interstage visit frequency and change in weight-for-age z-score in this patient population.
AHRQ-funded; HS016957.
Citation: Hurst DM, Oster ME, Smith S .
Is clinic visit frequency associated with weight gain during the interstage period? A report from the Joint Council on Congenital Heart Disease National Pediatric Cardiology Quality Improvement Collaborative (JCCHD-NPCQIC).
Pediatr Cardiol 2015 Oct;36(7):1382-5. doi: 10.1007/s00246-015-1169-6.
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Keywords: Newborns/Infants, Obesity: Weight Management, Heart Disease and Health, Ambulatory Care and Surgery
Carey K
Price increases were much lower in ambulatory surgery centers than hospital outpatient departments in 2007-12.
This study examined the revenue side of ASC growth by using a large national claims database that contains information on actual prices paid. It found that for six common outpatient surgical procedures, prices paid to ASCs on the whole grew in line with general medical care prices, while overall prices paid to hospital outpatient departments for the same procedures climbed sharply.
AHRQ-funded; HS023780.
Citation: Carey K .
Price increases were much lower in ambulatory surgery centers than hospital outpatient departments in 2007-12.
Health Aff 2015 Oct;34(10):1738-44. doi: 10.1377/hlthaff.2015.0252..
Keywords: Ambulatory Care and Surgery, Healthcare Costs, Surgery
Rangachari P, Mehta R, Rethemeyer RK
Short or long end of the lever? Associations between provider communication of the "asthma-action plan" and outpatient revisits for pediatric asthma.
This study addresses the gap in understanding the extent of leverage that healthcare providers may have in preventing hospital revisits for asthma through effective communication of the Asthma-Action Plan (AAP) in the outpatient setting. The Children's Hospital of Georgia survey results suggest limited potential of effective provider communication of AAP in reducing outpatient revisits for pediatric asthma and indicate a need for broader community-based interventions to address patient life variables impacting self-management and hospital revisits for pediatric asthma.
AHRQ-funded; HS019785.
Citation: Rangachari P, Mehta R, Rethemeyer RK .
Short or long end of the lever? Associations between provider communication of the "asthma-action plan" and outpatient revisits for pediatric asthma.
J Hosp Adm 2015 Oct;4(5):26-39. doi: 10.5430/jha.v4n5p26.
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Keywords: Asthma, Children/Adolescents, Ambulatory Care and Surgery, Clinician-Patient Communication, Patient Self-Management
Robinson JC, Brown TT, Whaley C
Consumer choice between hospital-based and freestanding facilities for arthroscopy: Impact on prices, spending, and surgical complications.
The purpose of this study was to evaluate the impact of reference-based benefits on consumer choices, facility prices, employer spending, and surgical outcomes for orthopaedic procedures performed at ambulatory surgery centers. It found that the shift to reference-based benefits was associated with an increase in the utilization of freestanding ambulatory surgery centers by 14.3 percentage points for knee arthroscopy and by 9.9 percentage points for shoulder arthroscopy and a corresponding decrease in the use of hospital-based facilities.
AHRQ-funded; HS022098.
Citation: Robinson JC, Brown TT, Whaley C .
Consumer choice between hospital-based and freestanding facilities for arthroscopy: Impact on prices, spending, and surgical complications.
J Bone Joint Surg Am 2015 Sep 16;97(18):1473-81. doi: 10.2106/jbjs.o.00240..
Keywords: Surgery, Ambulatory Care and Surgery, Outcomes
Wiseman JT, Fernandes-Taylor S, Barnes ML
Conceptualizing smartphone use in outpatient wound assessment: patients' and caregivers' willingness to use technology.
The researchers surveyed a vulnerable patient population to evaluate smartphone capability and willingness to adopt this technology. Their survey demonstrated that an older patient cohort with significant comorbidity is able and willing to adopt a smartphone-based postoperative monitoring program.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Barnes ML .
Conceptualizing smartphone use in outpatient wound assessment: patients' and caregivers' willingness to use technology.
J Surg Res 2015 Sep;198(1):245-51. doi: 10.1016/j.jss.2015.05.011..
Keywords: Ambulatory Care and Surgery, Surgery, Telehealth, Health Information Technology (HIT), Injuries and Wounds, Adverse Events, Patient Safety, Caregiving
Ray KN, Chari AV, Engberg J
Opportunity costs of ambulatory medical care in the United States.
The authors aimed to quantify the opportunity costs for adults seeking medical care for themselves or others. Using the 2003-2010 American Time Use Survey, they found that total opportunity costs per year for all physician visits in the United States were $52 billion in 2010. They concluded that, for every dollar spent in visit reimbursement, an additional 15 cents were spent in opportunity costs.
AHRQ-funded; HS022989.
Citation: Ray KN, Chari AV, Engberg J .
Opportunity costs of ambulatory medical care in the United States.
Am J Manag Care 2015 Aug;21(8):567-74.
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Keywords: Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Ambulatory Care and Surgery
Wang V, Lee SY, Maciejewski ML
Inertia in health care organizations: a case study of peritoneal dialysis services.
The aim of this study was to examine whether strategic and selective factors were associated with the provision of peritoneal dialysis (PD) services in outpatient dialysis facilities in the United States between 1995 and 2003. It found little support for strategic influences and some evidence that selective factors were predictive of dialysis facilities’ PD provision.
AHRQ-funded; HS019479; HS000032.
Citation: Wang V, Lee SY, Maciejewski ML .
Inertia in health care organizations: a case study of peritoneal dialysis services.
Health Care Manage Rev 2015 Jul-Sep;40(3):203-13. doi: 10.1097/hmr.0000000000000024..
Keywords: Kidney Disease and Health, Ambulatory Care and Surgery
Suskind AM, Zhang Y, Dunn RL
Understanding the diffusion of ambulatory surgery centers.
The objective of this study was to understand potential facilitators and/or barriers to the introduction of freestanding ambulatory surgical centers (ASCs) in the United States. It found that ASCs were more likely to open in hospital service areas that were urban, had higher per capita income, and less competition for outpatient surgery.
AHRQ-funded; HS020927; HS018726.
Citation: Suskind AM, Zhang Y, Dunn RL .
Understanding the diffusion of ambulatory surgery centers.
Surg Innov 2015 Jun;22(3):257-65. doi: 10.1177/1553350614546004..
Keywords: Ambulatory Care and Surgery, Access to Care, Surgery
Olfson M, Druss BG, Marcus SC
Trends in mental health care among children and adolescents.
This study examined national trends in the use of outpatient mental health services by children and adolescents, focusing on the severity of mental health impairment. It found that outpatient mental health treatment and psychotropic-medication use in children and adolescents increased in the United States between 1996–1998 and 2010–2012. Youths with less severe or no impairment accounting for most of the absolute increase in service use.
AHRQ-funded; HS021112.
Citation: Olfson M, Druss BG, Marcus SC .
Trends in mental health care among children and adolescents.
N Engl J Med 2015 May 21;372(21):2029-38. doi: 10.1056/NEJMsa1413512..
Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Ambulatory Care and Surgery
Zhao B, Jose PO, Pu J
Racial/ethnic differences in hypertension prevalence, treatment, and control for outpatients in Northern California 2010-2012.
The purpose of this paper is to study the prevalence, treatment, and control of hypertension among rapidly--growing minority groups. The authors found substantial racial/ethnic variation in hypertension prevalence, treatment, and control in the study population in northern California. Filipino and non-Hispanic black women and men are at especially high risk for hypertension and may have more difficulty in achieving adequate blood pressure control.
AHRQ-funded; HS019815.
Citation: Zhao B, Jose PO, Pu J .
Racial/ethnic differences in hypertension prevalence, treatment, and control for outpatients in Northern California 2010-2012.
Am J Hypertens 2015 May;28(5):631-9. doi: 10.1093/ajh/hpu189.
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Keywords: Blood Pressure, Racial and Ethnic Minorities, Cardiovascular Conditions, Medication, Ambulatory Care and Surgery
Rinke ML, Chen AR, Milstone AM
Bringing central line-associated bloodstream infection prevention home: catheter maintenance practices and beliefs of pediatric oncology patients and families.
The researchers investigated (1) the extent to which best-practice central line maintenance practices were employed in the homes of pediatric oncology patients and by whom, (2) caregiver beliefs about central line care and central line-associated blood stream infection (CLABSI) risk, (3) barriers to optimal central line care by families, and (4) educational experiences and preferences regarding central line care. They concluded that interventions aimed at reducing ambulatory CLABSIs should target appropriate educational experiences for adult caregivers and patients and identify ways to improve compliance with best-practice care.
AHRQ-funded; HS021282.
Citation: Rinke ML, Chen AR, Milstone AM .
Bringing central line-associated bloodstream infection prevention home: catheter maintenance practices and beliefs of pediatric oncology patients and families.
Jt Comm J Qual Patient Saf 2015 Apr;41(4):177-85.
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Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Ambulatory Care and Surgery, Quality Improvement
Beadles CA, Ellis AR, Lichstein JC
First outpatient follow-up after psychiatric hospitalization: does one size fit all?
This study examined the timing of first outpatient follow-up and subsequent health care utilization for adults with serious mental illness (major depression or schizophrenia) and comorbid general medical conditions. It found that for patients not readmitted within 30 days, follow-up within 30 days appeared to be beneficial on the basis of subsequent service utilization.
AHRQ-funded; HS019659; HS000032.
Citation: Beadles CA, Ellis AR, Lichstein JC .
First outpatient follow-up after psychiatric hospitalization: does one size fit all?
Psychiatr Serv 2015 Apr;66(4):364-72. doi: 10.1176/appi.ps.201400081..
Keywords: Hospitalization, Behavioral Health, Healthcare Utilization, Ambulatory Care and Surgery
Zhou M, Daubresse M, Stafford RS
National trends in the ambulatory treatment of hypertension in the United States, 1997-2012.
The researchers examined trends in the use of antihypertensive therapies in the United States between 1997 and 2012. They found that annual hypertension treatment visits increased from 56.9 million treatment visits in 1997 to 83.3 million visits in 2008, then declined steadily to 70.9 million visits in 2012.
AHRQ-funded; HS018960.
Citation: Zhou M, Daubresse M, Stafford RS .
National trends in the ambulatory treatment of hypertension in the United States, 1997-2012.
PLoS One 2015 Mar 4;10(3):e0119292. doi: 10.1371/journal.pone.0119292..
Keywords: Blood Pressure, Ambulatory Care and Surgery, Medication
Hollingsworth JM, Funk RJ, Owen-Smith J
Assessing the reach of health reform to outpatient surgery with social network analysis.
The researchers used the tools of social network analysis to assess the proportion of outpatient surgery currently delivered in ambulatory surgery centers (ASCs) that are largely unconnected to nearby hospitals. Their study of all Florida ASCs and hospitals found that 83% of the $4.3 billion in charges for ASC-based care originate from facilities that have substantial integration with their local health care systems.
AHRQ-funded; HS020927; HS018726.
Citation: Hollingsworth JM, Funk RJ, Owen-Smith J .
Assessing the reach of health reform to outpatient surgery with social network analysis.
Ann Surg 2015 Mar;261(3):468-72. doi: 10.1097/sla.0000000000000880..
Keywords: Ambulatory Care and Surgery, Policy, Health Services Research (HSR)
Robinson JC, Brown T, Whaley C
Reference-based benefit design changes consumers' choices and employers' payments for ambulatory surgery.
The researchers analyzed the impact of reference-based benefit (RBB) designs on cataract surgery patients choice of less-expensive ambulatory surgery centers over more expensive hospital outpatient departments. Examining two groups of patients, one in plans incorporating RBB and the other in non-RBB plans, they found that the shift to RBB led to an 8.6 percent increase in ambulatory surgery centers as well as a 19.7 percent decrease in payments per procedure.
AHRQ-funded; HS022098
Citation: Robinson JC, Brown T, Whaley C .
Reference-based benefit design changes consumers' choices and employers' payments for ambulatory surgery.
Health Aff. 2015 Mar;34(3):415-22. doi: 10.1377/hlthaff.2014.1198..
Keywords: Ambulatory Care and Surgery, Eye Disease and Health, Health Insurance, Healthcare Costs, Health Insurance
Erickson KF, Mell MW, Winkelmayer WC
Provider visit frequency and vascular access interventions in hemodialysis.
This study sought to determine whether more frequent face-to-face provider (physician and advanced practitioner) visits lead to more procedures and therapeutic interventions aimed at preserving arteriovenous fistulas and grafts and improved vascular access outcomes. It found that more frequent face-to-ace provider visits were associated with more procedures and therapeutic interventions aimed at preserving vascular accesses, but not with prolonged vascular access survival.
AHRQ-funded; HS019178.
Citation: Erickson KF, Mell MW, Winkelmayer WC .
Provider visit frequency and vascular access interventions in hemodialysis.
Clin J Am Soc Nephrol 2015 Feb 6;10(2):269-77. doi: 10.2215/cjn.05540614..
Keywords: Care Management, Dialysis, Kidney Disease and Health, Outcomes, Ambulatory Care and Surgery
Dalton VK, Liang A, Hutton DW
Beyond usual care: the economic consequences of expanding treatment options in early pregnancy loss.
The objective of this study was to estimate the economic consequences of expanding options for early pregnancy loss treatment beyond expectant management and operating room surgical evacuation (usual care). It found that the cost per case was $241.29 lower for women undergoing treatment in the expanded care model as compared with the usual care model.
AHRQ-funded; HS015491.
Citation: Dalton VK, Liang A, Hutton DW .
Beyond usual care: the economic consequences of expanding treatment options in early pregnancy loss.
Am J Obstet Gynecol 2015 Feb;212(2):177.e1-6. doi: 10.1016/j.ajog.2014.08.031..
Keywords: Healthcare Costs, Pregnancy, Treatments, Ambulatory Care and Surgery
Galarraga JE, Mutter R, Pines JM
AHRQ Author: Mutter R
Costs associated with ambulatory care sensitive conditions across hospital-based settings.
The objective of this study was to identify the cost differences in payments and charges for ambulatory care-sensitive conditions (ACSC) visits in three different hospital-based settings: outpatient visits, ED visits, and inpatient admissions. After adjusting for patient demographics and comorbid conditions, charges for an inpatient ACSC visit were four times higher ($11,414 vs. $2,563) when compared to an ED visit.
AHRQ-authored.
Citation: Galarraga JE, Mutter R, Pines JM .
Costs associated with ambulatory care sensitive conditions across hospital-based settings.
Acad Emerg Med. 2015 Feb;22(2):172-81. doi: 10.1111/acem.12579..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Emergency Medical Services (EMS), Ambulatory Care and Surgery, Inpatient Care
Singer SJ, Reyes Nieva H, Brede N
Evaluating ambulatory practice safety: the PROMISES project administrators and practice staff surveys.
This study reports findings from the baseline practice staff and administrator surveys designed as part of the PROMISES Project to assess safety and malpractice risks in the ambulatory setting. It found that administrators frequently reported important safety systems and processes were absent. Suboptimal or incomplete implementation of referral and test result management systems were related to staff perceptions of their quality.
AHRQ-funded; HS019508.
Citation: Singer SJ, Reyes Nieva H, Brede N .
Evaluating ambulatory practice safety: the PROMISES project administrators and practice staff surveys.
Med Care 2015 Feb;53(2):141-52. doi: 10.1097/mlr.0000000000000269..
Keywords: Ambulatory Care and Surgery, Patient Safety, Medical Liability, Provider
Viswanathan M, Kahwati LC, Golin CE
Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis.
Medication therapy management (MTM) services (also called clinical pharmacy services) aim to reduce medication-related problems and their downstream outcomes. The purpose of this study was to assess the effect of MTM interventions among outpatients with chronic illnesses. The investigators graded the evidence as insufficient for most outcomes because of inconsistency and imprecision that stemmed in part from underlying heterogeneity in populations and interventions.
AHRQ-funded; 290201200008I.
Citation: Viswanathan M, Kahwati LC, Golin CE .
Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis.
JAMA Intern Med 2015 Jan;175(1):76-87. doi: 10.1001/jamainternmed.2014.5841..
Keywords: Medication, Ambulatory Care and Surgery, Chronic Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research, Provider: Pharmacist, Provider
Moyer VA, Papile LA, Eichenwald E
An intervention to improve transitions from NICU to ambulatory care: quasi-experimental study.
The authors tested whether a multifaceted intervention that included a health coach to assist families and an enhanced personal health record to improve the quality of information available to parents and community professionals would decrease adverse events and improve family assessment of the transition of infants born prematurely or with complex medical problems to home. They found that a multicomponent discharge intervention designed to address specific problems identified using Healthcare Failure Modes and Effects Analysis did not reduce certain adverse outcomes in the post-discharge period.
AHRQ-funded; HS017889.
Citation: Moyer VA, Papile LA, Eichenwald E .
An intervention to improve transitions from NICU to ambulatory care: quasi-experimental study.
BMJ Qual Saf 2014 Dec;23(12):e3. doi: 10.1136/bmjqs-2012-001726.
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Keywords: Neonatal Intensive Care Unit (NICU), Ambulatory Care and Surgery, Patient Safety, Quality Improvement, Transitions of Care
Hollingsworth JM, Birkmeyer JD, Ye Z
Specialty-specific trends in the prevalence and distribution of outpatient surgery: implications for payment and delivery system reforms.
The authors sought to assess the prevalence and distribution of outpatient surgery across specialties. They found that several specialties - urology, gastroenterology, plastic surgery, and ophthalmology - perform most of their cases in outpatient settings. They suggested that incorporating these findings into the design of future payment and delivery system reforms will help to ensure adequate surgeon exposure to the efficiency gains that evolve from them.
AHRQ-funded; HS020927; HS018346.
Citation: Hollingsworth JM, Birkmeyer JD, Ye Z .
Specialty-specific trends in the prevalence and distribution of outpatient surgery: implications for payment and delivery system reforms.
Surg Innov 2014 Dec;21(6):560-5. doi: 10.1177/1553350613520515.
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Keywords: Ambulatory Care and Surgery, Surgery, Healthcare Delivery, Payment
Bish EK, El-Amine H, Steighner LA
A socio-technical, probabilistic risk assessment model for surgical site infections in ambulatory surgery centers.
The researchers sought to identify the risk factors associated with surgical site infections (SSIs) resulting from procedures performed at ambulatory surgery centers (ASCs) and to design an intervention to mitigate the likelihood of SSIs for the most common risk factors that were identified by the socio-technical probabilistic risk assessment (ST-PRA) tool for a particular surgical procedure. They found that failure to protect the patient effectively accounted for 51.9% of SSIs in the ambulatory care setting. Critical components of this event included skin preparation, antibiotic administration, staff training, proper response to glove punctures during surgery, and adherence to surgical preparation rules related to the wearing of jewelry, watches, and artificial nails. They determined that, assuming a 75% reduction in noncompliance on any combination of 2 of these 5 components, the risk for an SSI decreased.
AHRQ-funded; 290200600019I.
Citation: Bish EK, El-Amine H, Steighner LA .
A socio-technical, probabilistic risk assessment model for surgical site infections in ambulatory surgery centers.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S133-41. doi: 10.1086/677824.
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Keywords: Ambulatory Care and Surgery, Risk, Surgery, Healthcare-Associated Infections (HAIs), Patient Safety, Injuries and Wounds, Adverse Events