RT Journal
A1 Mitchell JM
T1 EFfect of physician ownership of specialty hospitals and ambulatory surgery centers on frequency of use of outpatient orthopedic surgery
JF Archives of Surgery
JO Archives of Surgery
YR 2010
FD August 1
VO 145
IS 8
SP 732
OP 738
DO 10.1001/archsurg.2010.149
UL http://dx.doi.org/10.1001/archsurg.2010.149
AB Background 
    Physician-owned specialty hospitals and ambulatory surgery centers have become commonplace in many markets throughout the United States. Little is known about whether the financial incentives linked to ownership affect frequency of outpatient surgery.Objective 
    To evaluate if financial incentives linked to physician ownership influence frequency of outpatient orthopedic surgical procedures.Design and Setting 
    We analyzed 5 years of claims data from a large private insurer in Idaho to compare frequency by orthopedic surgeon owners and nonowners of surgical procedures that could be performed in either ambulatory surgery centers or hospital outpatient surgery departments.
Main Outcome Measure 
    Frequency of use, calculated as number of patients treated with the specific diagnoses who received the surgical procedure of interest divided by the number of patients with such diagnoses treated by each physician.Results 
    Age- and sex-adjusted odds ratios indicate that the likelihood of having carpal tunnel repair was 54% to 129% higher for patients of surgeon owners compared with surgeon nonowners. For rotator cuff repair, the adjusted odds ratios of having surgery were 33% to 100% higher for patients treated by physician owners. The age- and sex-adjusted probability of arthroscopic surgery was 27% to 78% higher for patients of surgeon owners compared with surgeon nonowners.Conclusion 
    The consistent finding of higher use rates by physician owners across time clearly suggests that financial incentives linked to ownership of either specialty hospitals or ambulatory surgery centers influence physicians' practice patterns.