The measure defines the outcome as any (one or more), all-cause, acute, unplanned hospital visit within seven days of an outpatient general surgery performed at an ASC; a hospital visit includes any emergency department (ED) visit, observation stay, or unplanned inpatient admission.

Outcome Definition

The ASC General Surgery measure defines the outcome as any (one or more), all-cause, acute, unplanned hospital visit within seven days of an outpatient general surgery performed at an ASC; a hospital visit includes any emergency department (ED) visit, observation stay, or unplanned inpatient admission.

Time Period for Data

Numerator time window: Seven days after ASC procedures for unplanned hospital visits.

Planned Hospital Visits

The measure outcome includes hospital visits within the first seven days following the procedure, unless that inpatient admission is deemed a "planned" admission as defined by the measures Planned Admissions Algorithm (PAA).

The target population for this measure is Medicare FFS patients aged 65 years and older, undergoing selected outpatient general surgery procedures in ASCs that are within the scope of general surgery training. Specifically, the cohort of procedures includes the following types of procedures: abdominal, alimentary tract, breast, skin/soft tissue, wound, and varicose vein.

The measure does not include procedures that:

Are on the ASC list of covered procedures that do not involve or require major or prolonged invasion of body cavities, extensive blood loss, major blood vessels, or care that is emergent or life-threatening.

Are part of the Agency for Healthcare Research and Quality (AHRQ) Clinical Classifications Software's (CCS's) gastrointestinal endoscopy, endocrine, or vascular procedures, other than varicose vein procedures, as reasons for hospital visits are typically related to patients' underlying comorbidities.

National Quality Forum 2022 Key Rural Measures: An Update List of Measures to Advance Rural Health Priorities, Draft 1, page 1-26

Download from: www.qualityforum.org/Publications/2022/08/2022KeyRural_Measures__An_Updated_List_of_Measures_to_Advance_Rural_Health_Priorities.aspx

Technical specifications: p4qm.org/measures/3357