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Research study

Evidence-Informed Facility Standards

- back to the Public Health Approaches to Abortion Project

The past decades have seen marked increases in the number and scope of procedures and surgeries performed in outpatient settings. An estimated 926,000 abortions take place annually in the U.S., making it among the most common outpatient procedures. Recently, an increasing number of states have enacted laws that impose specific requirements for facilities in which abortions are performed.  In most cases, these laws are deployed without evidence that these more stringent facility standards increase patient safety.

The Evidence-Informed Facility Standards Project explores what evidence-informed facility standards would look like in the context of abortion. Specifically, researchers: describe the existing evidence-base related to general standards for freestanding outpatient facilities that perform procedures; conduct new research to begin building an evidence-base related to facility standards in the context of abortion; and describe how facility standards are established in other contexts, where abortion-related political influences are not present. Our goal is to use these research findings to inform conversations around evidence-informed facility standards in the context of abortion and to ground future efforts to establish standards in this area in the best available evidence. These research projects include:

Completed and ongoing work

State Law Approaches to Facility Regulation of Abortion and Other Office Interventions – Many states regulate facilities that provide abortions differently than facilities that provide other office-based surgeries, procedures and/or anesthesia. This study compares the prevalence, applicability and requirements of facility laws that govern: office interventions generally; abortion specifically; or other procedures specifically. For more on state law approaches to facility regulation of abortion and other offices, download our issue brief and infographic.

Relationship between facility requirements and patient outcomes for outpatient procedures: a systematic review – This systematic review of the literature examines the effects of outpatient facility type (ambulatory surgery center vs. office) and specific facility characteristics (e.g., facility accreditation, emergency response protocols, clinician qualifications, physical plant characteristics, other policies) on patient safety, patient satisfaction and service availability in non-hospital-affiliated outpatient settings. For more on the relationship between facility requirements and patient outcomes for outpatient procedures, download our issue brief.

The Use of Research Evidence in Developing Facility Standards –This project aims to describe how evidence has been used in the development of facility standards for procedures commonly done in outpatient settings. Through key informant interviews with clinicians involved in standards development, the study examines the motivations, processes, arguments, and evidence used to set such standards. For more on the use of research evidence in developing facility standards, download our issue brief.

Cost and Complications in Ambulatory Surgery Centers vs. Offices/Clinics – This project utilizes a national insurance claim database to examine how safety and cost of abortions vary across offices and ambulatory surgery centers as well as how safety of miscarriage treatment varies across offices and ambulatory surgery centers. For more on cost and complications in ambulatory surgery centers vs. offices/clinics, download our issue briefs on abortion, on miscarriage treatment, and this infographic.

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ANSIRH is a program within the UCSF Bixby Center for Global Reproductive Health and is a part of UCSF's Department of Obstetrics, Gynecology & Reproductive Sciences.

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