Cost Savings, Successful Outcomes, Found in New Anesthesiologist Model of Care

Using a comprehensive preoperative triage system directed by anesthesiologists, a team of researchers at the Ochsner Medical Center in New Orleans has shown marked reductions in patient charges for common medical tests – without sacrificing quality of care and successful outcomes. Their findings were presented today at the ANESTHESIOLOGY™ 2012 annual meeting.

Patient charges for the seven most common medical tests were reduced by $18,187 for every 100 patients with mild disease, and $20,664 for every 100 patients with moderate disease.

Lead study author Sharon Carrillo, M.D., M.S. and her group used methods of coordinated care in the surgical setting, in which anesthesiologist-directed facilities “join together like a concerned family to oversee a patient’s surgical experience” and create substantive savings in health care.

“Our premise is that dedicated anesthesiologists likely have more insight into surgical stresses and test requirements than primary care physicians who, with surgeons, still predominantly ‘clear’ most patients in U.S. clinical practice,” said Dr. Carrillo.

In the study of nearly 1,400 patients, anesthesiologists at Ochsner Medical Center reviewed available medical records, ordered tests and requested appropriate consults for total knee and total hip replacement surgeries. Among several other cost-saving practices, the study authors replaced costlier comprehensive metabolic profile tests with a basic metabolic profile, obtained EKG tests only for healthy patients over 65, and avoided duplicate X-rays by administering them only when called for because of symptoms or previous examination findings.

Interestingly for the Ochsner researchers, their findings were observed during a period in which an external auditor determined that major complications associated with total knee and total hip surgeries at the institution were decreasing.

“We believe that we have successfully reduced the cost passed on to patients without sacrificing successful outcomes,” said Dr. Carrillo. “Our goal is to expand the triage process to other surgical groups in hopes of further cost-containment and improved patient satisfaction at our institution.”

The findings of the study highlight the important role anesthesiologists can serve in reducing costs through effective care coordination in the acute care setting – a concept endorsed by the ASA in its Perioperative Surgical Home™ model of care.