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Unnecessary preoperative investigations: evaluation and cost analysis
1Surgical and Anesthesiology Services, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
The American Surgeon
|August 1, 1996
Summary
Unnecessary preoperative investigations are common in ambulatory surgery, costing an average of $47-$80 per patient. Limiting tests to clinical indications can reduce costs without compromising patient safety.
Area of Science:
- Healthcare Management
- Health Economics
- Surgical Care
Background:
- Rising healthcare expenditures necessitate cost-containment strategies in medical practices.
- Preoperative investigations are a significant component of ambulatory surgery costs.
Purpose of the Study:
- To evaluate the necessity of preoperative investigations in ambulatory surgery.
- To determine the cost-effectiveness of current preoperative testing protocols.
Main Methods:
- Review of 60 randomly selected ambulatory surgery patient records.
- Assessment of test necessity based on clinical indications.
- Cost analysis at a Department of Veterans Affairs Medical Center (VAMC) and a community hospital.
Main Results:
- Two-thirds of preoperative investigations were deemed inappropriate.
- Unnecessary costs averaged $47 per patient at the VAMC and $80 at the community hospital.
- Potential annual savings of $11,757.50 identified at the VAMC.
Conclusions:
- Many preoperative investigations lack clinical indication and contribute to healthcare costs.
- Implementing evidence-based guidelines for preoperative testing can reduce expenses.
- Reducing unnecessary tests does not compromise patient quality or safety.