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Unindicated preoperative testing: ASA physical status and financial implications
1Department of Anesthesiology, University of Rochester School of Medicine, NY 14642, USA.
Journal of Clinical Anesthesia
|September 1, 1997
Summary
Many preoperative lab tests ordered by surgeons are unnecessary. Eliminating these unindicated tests can significantly reduce healthcare costs for hospitals, particularly in managed care settings.
Area of Science:
- Anesthesiology
- Health Economics
- Surgical Pre-assessment
Background:
- Preoperative laboratory testing is a routine part of surgical preparation.
- The necessity and indications for preoperative tests are often debated.
- Variations in ordering practices can impact patient care and healthcare costs.
Purpose of the Study:
- To compare the ordering of unindicated preoperative laboratory tests between healthy (ASA physical status I and II) and sicker (ASA physical status III) patients.
- To evaluate the financial implications of unindicated preoperative testing at a university hospital.
Main Methods:
- A prospective, cross-sectional study was conducted.
- 312 patients undergoing elective surgery were analyzed.
- Anesthesiologists reviewed surgeon-ordered tests for indication in relation to patient's ASA physical status.
Main Results:
- An average of 72.5% of surgeon-ordered tests were deemed not indicated by anesthesiologists.
- Sicker patients (ASA III) had fewer unindicated tests ordered compared to healthier patients (ASA I and II).
- Eliminating unindicated tests could save the hospital approximately $80,000 annually.
Conclusions:
- A significant proportion of preoperative laboratory tests ordered by surgeons are not indicated.
- Reducing unindicated testing offers potential cost savings for hospitals.
- The financial impact of reducing unnecessary tests varies depending on the healthcare payment model (fee-for-service vs. managed care).