SITE OF SERVICE, ANESTHESIA, AND POSTOPERATIVE PRACTICE PATTERNS FOR OCULOPLASTIC AND ORBITAL SURGERIES

Purpose: Variations in physician practice patterns, particularly with reference to cost-intensive resource utilization, are increasingly bei ng scrutinized. However, little information is currently available reg arding physician practice patterns for oculoplastic surgery. Methods: The authors surveyed members of the American Society of Ophthalmic Pla stic and Reconstructive Surgery regarding their most common site of se rvice, type of anesthesia, and first postoperative week of follow-up f or 15 selected eyelid, lacrimal, and orbital procedures. Results: The majority of eyelid and lacrimal surgeries are currently performed on a n out-patient basis (hospital out-patient, ambulatory surgery center, or office), typically using local anesthesia with or without sedation. Regional differences were noted. Physicians in western states showed a greater tendency toward office-based surgery for procedures such as blepharoplasty and ptosis repair. Orbital procedures were performed mo re frequently as a hospital inpatient surgery, under general anesthesi a. Patterns of follow-up within the first postoperative week varied co nsiderably for most procedures. Compared with admitting practices in 1 987, an obvious trend toward out-patient surgery was noted.Conclusion: Variations in practice patterns will assume greater importance as the pressure for cost-containment increases. Total costs are affected by physician choices for site of service and type of anesthesia. This stu dy allows surgeons who perform oculoplastic procedures to compare thei r practices with a national group specializing in such surgery. Furthe r outcome-oriented studies are needed to develop practice guidelines f or ''preferred patterns'' of care.