Date of Award


Document Type


Degree Name

Doctor of Health Administration


College of Health Professions

First Advisor

Jillian B. Harvey

Second Advisor

Walter Jones

Third Advisor

Shelly E. Turner

Fourth Advisor

Lisa K. Saladin


The shift of care into an ambulatory setting calls for improved transparency of quality outcomes across care settings. Past analysis comparing hospitals and ASCs has focused on patient outcomes, but is limited by issues of risk adjustment. We applied methods used by CMS in the nursing home setting to standardize facility-level survey data and measure quality across hospitals and ASCs in West Central Florida. We then applied a four-point star system, ranking institutions based on aggregate scores. We found that ASCs are 4.68 times more likely than hospitals to achieve the best rating of 4 stars, whereas ASCs chances of earning 1 star are 78% lower than hospitals. As there was a wide discrepancy in ratings across individual ASCs and hospitals, state survey data represents a readily available resource for policymakers to improve consumer interests in determining their site of care.


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