The Use of Population Segmentation and Social Determinants of Health by Executives in Establishing or Modifying an Ambulatory Surgery Center
Date of Award
Spring 2026
Document Type
Dissertation
Degree Name
Doctor of Healthcare Administration (DHA)
Committee Chair
David Meckstroth
Committee Member
Fabienne Royale-Larkins
Committee Member
Lori Salgado
Abstract
Over the past several decades, Ambulatory Surgery Centers (ASCs) have grown substantially in both number and utilization, driven by advancements in procedural safety, high levels of patient satisfaction, and the lower costs associated with outpatient surgical care. The ongoing migration of surgical procedures from inpatient hospitals to outpatient or ASC settings reflects the healthcare industry’s emphasis on delivering high-quality, cost-effective care. As reimbursement models continue to shift toward value-based systems, healthcare organizations must increasingly prioritize cost management alongside population and community health considerations. Within this evolving context, the inclusion of population segmentation and social determinants of health (SDOH) factors—together with other determinants such as location, surgical scope, payer mix, market demand, and reimbursement—becomes essential when establishing or modifying ASCs. Existing literature identifies components of population segmentation and SDOH being considered by ASC executives in their decision-making processes, but it is fragmented and inconsistent. The purpose of this exploratory qualitative study was to explore the extent to which ASC executives in the United States incorporate population segmentation and SDOH factors into their decision-making processes regarding ASC development or modification. A total of 18 ASC executives participated in semi-structured interviews, and qualitative data were analyzed using Bryman’s four stages of coding to identify primary themes and patterns. The findings of the study indicate that population segmentation and SDOH are important factors in accessing ASC services, aligning services, and providing care to patients. The significance of this research lies in its potential to inform strategies that enhance patient services, strengthen community health outcomes, and promote more equitable health planning in communities served by ASCs, particularly those that are underserved.
Recommended Citation
Smith, Heather Marie, "The Use of Population Segmentation and Social Determinants of Health by Executives in Establishing or Modifying an Ambulatory Surgery Center" (2026). All Doctoral Student Dissertations. 255.
https://fuse.franklin.edu/docpub/255
