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The number of outpatient surgery centers and patient visits at those centers surged across Pennsylvania during the two years ending June 30, 2003, but that growth so far has had little impact on outpatient care given at the state's acute care hospitals, new data shows.

The independent Pennsylvania Health Care Cost Containment Council said that from July 2001 to June 2003, the number of outpatient surgical centers jumped 44.9 percent, to 113 from 78. And since July of last year through June, an additional 48 so-called surgicenters have opened.

In the eight-county Southwestern Pennsylvania region, including Allegheny, Westmoreland and Fayette counties, there were 22 ambulatory surgery centers open for business, up from 14 two years earlier. In the most recent year, they generated patient revenue of $49.3 million. A single surgicenter in Indiana County had net patient revenue in the year ending June 30, 2003, of $3.3 million.

Over the same two-year time frame, the number of patients visiting surgicenters statewide jumped a whopping 82.9 percent, to 510,781 from 279,335. During fiscal year 2003, 19 percent of 1.7 million outpatient surgical and diagnostic procedures performed statewide were done at surgery centers.

The sharp increases in the number of surgicenters and patient volume did not surprise industry experts.

"The number of outpatient surgery centers will continue to increase, but probably at a slower rate than you now are seeing, perhaps 5 percent annually," said Jon Vick, president of surgery center consulting firm ASCs Inc., Valley Center, Calif. Vick said Pennsylvania continues to play catch up in terms of surgery center openings because, prior to 1997, such facilities had to have state approval to build.

"The number of outpatient procedures performed at surgery centers will continue to increase as technology and medications improve, allowing more procedures to be safely performed away from the hospital operating room," Vick said. "And outpatient procedures will continue to migrate away from hospital outpatient centers to non-hospital settings because they are less expensive."

While surgicenters continue to increase both in numbers and patient volume, they have not had a major effect on the volume of outpatient care performed by hospital outpatient facilities, nor put a big dent in outpatient revenue at hospitals, the council data shows. Total patient revenue of $315 million in fiscal year 2003 for surgicenters was only 4 percent of the total outpatient revenue received by hospitals, while surgery center visits were equal to just 2 percent of outpatient visits to hospitals.

"Even though hospitals yell and scream about ambulatory surgery centers, they free up hospital operating rooms to perform more technically difficult procedures, and they tend to generate more revenue to the hospitals," Vick said.

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