Key result
Information technology-based patient and surgery specific preoperative assessment reduced the average total cost per patient by 81.95% and hospital visits by 50% compared to routine testing, without increasing cancellations or complications.
Why the study?
Despite negative recommendations, routine preoperative testing practice is nearly universal, prompting evaluation of an information-technology-based preanaesthetic assessment platform on outcomes and cost.
Does an IT-based joint preoperative assessment reduce unnecessary investigations and costs in patients undergoing elective non-cardiac surgery?
Observational (n=114)
No
Does an IT-based joint preoperative assessment reduce unnecessary investigations and costs in patients undergoing elective non-cardiac surgery?
An IT-based joint preoperative assessment significantly reduces the number of preoperative investigations, hospital visits, and costs without adversely affecting perioperative outcomes in patients undergoing elective non-cardiac surgery.
May safely cut preoperative costs and visits; hypothesis-generating and requires RCTs before practice change.
BACKGROUND: Despite negative recommendations, routine preoperative testing practice is nearly universal. Our aim is to bring the healthcare providers on one platform by using information-technology based preanaesthetic assessment and evaluate the routine preoperative testing's impact on patient outcome and cost. METHODS: A prospective, non-randomised study was conducted in a teaching hospital during January 2019-August 2020. A locally developed software and cloud-computing were used as a tool to modify preanaesthesia evaluation. The number of investigations ordered, time taken, cost incurred, were compared with the routine practice. Further data were matched as per surgical invasiveness and the patient's physical status. Appropriate tests compared intergroup differences and p-value <0.05 was considered significant. Results: Data from 114 patients (58 in routine and 56 in patient and surgery specific) were analysed. Patient and surgery specific investigation led to a reduction in the investigations by 80-90%, hospital visit by 50%, and the total cost by 80%, without increasing the day of surgery cancellation or complications. CONCLUSION: Information technology-based joint preoperative assessment and risk stratification are feasible through locally developed software with minimal cost. It helps in applying patient and surgery specific investigation, reducing the number of tests, hospital visit, and cost, without adversely affecting the perioperative outcome. The application of the modified method will help in cost-effective, yet quality and safe perioperative healthcare delivery. It will also benefit the public from both service and economic perspective.
No takes yet. Share an insight, caveat, or question.
Karim et al. (2021) conducted an observational in Elective non-cardiac surgery (n=114). Information technology-based joint preoperative assessment (patient and surgery specific investigations) vs. Routine preoperative testing practice was evaluated on Average total cost per patient (Indian Rupees) (81.95% reduction, p=<0.0001). Information technology-based patient and surgery specific preoperative assessment reduced the average total cost per patient by 81.95% and hospital visits by 50% compared to routine testing, without increasing cancellations or complications.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: