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Hospital based care following ambulatory cosmetic surgery
Dallas Hansen M.D.
Justin P. Fox M.D., M.H.S.
Anita A. Vashi M.D., M.P.H.
Cary P. Gross M.D.
R. Michael Johnson, M.D
Wright State University
2013-03-14
Presenter: Dallas Hansen, MD
Affidavit:
Ohio Valley Society of Plastic Surgeons,
This letter is for Dr. Dallas Hansen and his abstract submission
entitled "Hospital based care following ambulatory cosmetic surgery."
I certify that the material proposed for presentation in this abstract
has not been published in any scientific journal or previously
presented at a major meeting. The majority of the work for this
abstract was completed by Dr. Hansen and represents his original work.
Thank you for considering his work for presentation.
Director Name: R. Michael Johnson, M.D.
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: Aesthetics
Background: 14.6 million cosmetic plastic surgery procedures were performed in the United States in 2012. Complications from these procedures are infrequent, but may be a source of significant morbidity and economic burden to the patient when hospital-based care is required.
Purpose: To describe the frequency of hospital-based care, defined as emergency department (ED) visits and inpatient admissions, following cosmetic plastic surgery performed in the ambulatory setting.
Methods: Utilizing the 2008-2009 California, Florida, and Nebraska ambulatory surgery databases from the Health Care Utilization Project (HCUP), we identified patients who underwent ten common cosmetic procedures between July 2008 and September 2009. We then identified all hospital-based visits within 30-days of discharge from corresponding inpatient and ED databases. 30-day hospital-based care rates were calculated and their associated diagnoses and charges recorded.
Results: We identified 63,878 patients who were predominantly female (78.8%) and self-pay (41.5%). The two most common procedures performed were blepharoplasty (39.2%) and breast augmentation (14.9%). There were 2,387 ED visits and hospital admissions for a hospital-based care rate of 3.6%. The majority were ED encounters (67.4%) and most listed private insurance (56.6%) as the anticipate payer. The median charge was $2,173 and $26,321 for ED visits and hospital admissions respectively. Hospital-based utilization by procedure varied from a low of 2.2% (breast augmentation) to a high of 9.6% (abdominoplasty).
Conclusions: Ambulatory cosmetic surgery is associated with a measurable need for hospital-based care after discharge. Patients and physician should be aware of this need and associated charges before undergoing elective cosmetic surgery.
