Key result
Preoperative anesthesia consultations doubled from 2003 to 2017, with 19.32% of consults for patients who did not proceed to surgery and 37.23% of surgical patients being ASA class I or II.
Why the study?
Physician consultations are a limited resource, prompting an evaluation of preoperative anesthesia consultation usage patterns to identify opportunities for efficiency.
Cohort (n=2,023,499)
Yes
Answers are grounded in this paper and cite their sources.
A significant proportion of preoperative anesthesia consultations in Ontario are utilized by patients who do not proceed to surgery or are low-risk (ASA I/II), suggesting opportunities for resource optimization.
ABSTRACT ¬ Rationale, aims and objectives: Physician consultations are a limited resource. Anesthesiologists provide anesthesia during surgery and procedures, prepare patients for surgery in preoperative clinics, and provide postoperative care. This study sought to evaluate current consultation usage patterns, with an aim to determine possible opportunities for efficiency. Method: A retrospective comprehensive population-based cohort study was performed, evaluating all hospitals in the Canadian province of Ontario from 2002-2018. The main outcome measures were American Society of Anesthesiologists (ASA) classification of the patients, and whether the patients underwent surgery within 3 months following the anesthesia consultation. Results: A cohort of 2,023,499 patients, and a total of 2,920,100 preoperative anesthesia consultations was obtained. The number of consults per year doubled between 2003 (112,983/year) and 2017 (246,427/year). Each year, an average of 19.32% of the consults (range: 17.69-20.49%) were for patients that did not progress to having surgery. Of those that did have surgery following the anesthesia consult, 37.23% were ASA Classification I or II. The most common surgical procedures (percent of total) following anesthesia consult were: Knee implantation of internal device (9.46%), hip implantation of internal device (5.84%), cataract excision (4.09%), repair of muscle of chest/abdomen (3.31%), uterus excision (2.76%), and gallbladder excision (2.67%). Conclusions: This study reveals data on utilization and trends over time of preoperative anesthesia consultations. Potential opportunities for optimization were found, including patients who did not proceed to surgery, and healthier patients undergoing low to moderate risk surgery that may not require consultation.
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Dion et al. (2020) conducted a cohort in Preoperative anesthesia consultations (n=2,023,499). Preoperative anesthesia consultation was evaluated on American Society of Anesthesiologists (ASA) classification and whether patients underwent surgery within 3 months following consultation. Preoperative anesthesia consultations doubled from 2003 to 2017, with 19.32% of consults for patients who did not proceed to surgery and 37.23% of surgical patients being ASA class I or II.
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