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Is physician anesthesia cost-effective?

J P Abenstein1, Kirsten Hall Long, Brian P McGlinch

  • 1Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905, USA. abenstein.john@mayo.edu

Anesthesia and Analgesia
|February 26, 2004
PubMed
Summary
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Physician anesthesia care is more cost-effective than nonmedically directed nurse anesthetists, potentially saving money and improving life expectancy. This analysis supports the physician-led anesthesia model.

Area of Science:

  • Anesthesiology
  • Health Economics
  • Healthcare Policy

Background:

  • The cost-effectiveness of nurse anesthetists versus anesthesiologists is a contentious issue in anesthesia.
  • Recent studies indicate better patient outcomes with physician-directed nurse anesthetists.

Purpose of the Study:

  • To estimate the cost-effectiveness of physician-directed anesthesia compared to nonmedically directed nurse anesthetists from a payer's perspective.
  • To provide economic evidence supporting the physician anesthesia model of care.

Main Methods:

  • Electronic survey of US anesthesia practices to gather reimbursement data.
  • Development of a model to calculate cost-effectiveness ratios (dollars per year of life saved).
  • Sensitivity analyses were performed across different payer types and assumptions.

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Main Results:

  • Physician anesthesia was found to be cost-saving for both younger privately insured patients (-$2601/YLS) and elderly Medicare patients (-$4410/YLS).
  • Cost-effectiveness ratios varied from -$4410 to $38778/YLS depending on payer and assumptions.
  • Results were most sensitive to reimbursement rates and provider mortality assumptions.

Conclusions:

  • Physician-directed anesthesia care may offer improved patient outcomes at cost savings or a reasonable societal cost.
  • The economic analysis provides evidence favoring the physician anesthesia model for cost-effectiveness.