Starting almost 20 years ago, more people have been getting surgery as outpatients rather than staying overnight in hospitals.
Why not, right? Advances in care have made it possible for doctors to perform many operations and procedures quickly and safely outside hospitals. And avoiding a hospital stay saves patients time and insurers money.
But there is a catch, according to a study just published in JAMA: Risks of infection are a lot higher than they should be.
Random inspections of nearly 70 surgery centers in three states found that two-thirds had at least one significant lapse in controlling infections. One common problem was the use of single-dose medication vials for more than one patient -- found in 28 percent of the inspections.
Practices like that exposed tens of thousands of patients to potential infection with hepatitis C in Las Vegas a few years back.
Other problems discoverd in the inspections described in the JAMA paper included lapses in washing hands and wearing sterile gloves, sterilization of instruments and handling of equipment to measure blood sugar.
The JAMA study had limitations, such as only collecting data at a single point in time and not counting up the frequency of lapses.
Still, an accompanying editorial, says extrapolating the findings nationally would mean that "several million patients" of surgery centers each year could be at risk of an avoidable infections. "This risk is not acceptable and must be corrected immediately and definitively," writes Dr. Philip Barie, a New York surgeon, in the editorial.
The trade group for surgery centers said in a statement that it took the study seriously and that its members are working to address the concerns. The group defended its members practices, however, saying the rates of complications and infections after outpatient procedures are low.