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[Effective preoperative studies in outpatient anesthesiology]
J J Langemeijer1, M H Hemrika, J J de Lange
1St. Antonius Ziekenhuis, afd. Anesthesiologie, Nieuwegein.
Objective:
To determine the effect of preoperative patient evaluation by the anaesthesist instead of the surgeon on the requests for additional specialist consultation and investigation and on the costs involved.
Setting:
St. Antonius Hospital, Nieuwegein, the Netherlands.
Design:
Descriptive.
Methods:
From June 1993 to June 1995 (2 years), 20,000 patients were evaluated preoperatively by an anaesthesiologist in the outpatient clinic, additional investigations and consultations were requested only when indicated. The data were compared with the routine minimum package of additional requests advised by the Health Council of the Netherlands. The costs were calculated.
Results:
During the 2-year period there were 19 requests for additional laboratory investigations, ECG or chest X-ray. Consultations of a cardiologist, pulmonologist or internist were required in 137 patients (< 1.4%). Of these patients 67% required further treatment. Elimination of routine consultations and investigations led to a decrease in preoperative hospital admissions. This resulted in savings of approximately 1,300,000 Dutch guilders.
Conclusions:
Preoperative outpatient anaesthetic evaluation reduces the number of investigations and consultations and can result in a significant decrease in costs.