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- W2094367050 abstract "A USTRALIA IS A British based democracy with a population of 18.3 million. The shrinking health dollar has forced health care professionals to consider more efficient ways of providing patient care. A s ' a result, anthulatory surgery is in a growth phase both in the private and public sectors. The first modern, freestanding ambulatory center in Australia, The Dandenong Surgicentre, was estabIished in I982. Since that time there has been a steady increase in the number of private freestanding centers, with a 31% increase from 1994 to 1997. Cm'rently there are 143 freestanding centers in Australia. Public hospitals are also changing to incorporate ambulatory surgery units, some as dedicated units, others as integrated units combined with inpatient facilities. For both groups the encompassing of ambulatory surgery principles has provided challenges and required changes in the sldHs of all those involved. It is difficult to estimate how much ambulatory surgery is being performed in Australia, as this varies enormously between the private and public sectors and between the various states of Australia. However, conservative estimates in public hospitals indicate that in 1994 a 29% rate increased to 33% by 1996 and is still growing. Warden z postulates that by the year 2000 public hospitals should perform 60% of all elective surgery on a ambulatory basis. Ambulatory surgery growth has been thlpaired by the lack of commercial incentives and conservatism within the medical profession. It has gained momentum recently with the enthusiasm of ambulatory surgery protagonists, and in the public hospitals it has been financially da'iveu as adm~rdstrators Iook for cheaper ways to provide health care and mechanisms to reduce the lengthy waiting lists. In the private sector, which provides health care to approximately 30% of the privately insured Australians, there are fewer incentives for ambulatory surgery patient management. However, in the future it is expected that with the reorganization of reimbursements to patients for ambulatory surgery as opposed to inpatient surgerysignificant changes may occur. One of the challenges facing us in ambulatory surgery in Australia is to maintain favorable patient outcomes with low complication rates. We are increasingly confronted with more ambulatory sttrgery patients who are less fit and who are undergoing more complex surgical procedures than in the past. To meet this challenge staff in ambula~ry surgery facilities, either private or public, large or small, are aware of the importance of monitoring their ambulatory surgary processes to facilitate improvements in patient outcome. Continuous quality improvement (CQI) programs evaluate and moultor the standards of care and are central to this issue. CQI teams from progressive Australian ambulatory surgery centers are now making significant improvements in patient outcome where ambulatory surgery systems are continuously monitored. 2-s" @default.
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- W2094367050 date "1997-09-01" @default.
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- W2094367050 title "Ambulatory anesthesia: The Australian perspective" @default.
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- W2094367050 doi "https://doi.org/10.1016/s0277-0326(97)80041-4" @default.
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