Trends in healthcare and the role of the anesthesiologist in the perioperative surgical home – the US perspective

PURPOSE OF REVIEW: Although advances in science are important, changes in population structure and developments in health policy have equally critical roles in shaping the future of anesthesia practice. Therefore, it is important for anesthesiologists to be aware of these trends and their implications. RECENT FINDINGS: As in other industrialized nations, population aging implies that patients presenting for elective surgery in future decades will be older and sicker. Nevertheless, in part for economic reasons, the fraction of surgeries performed in the ambulatory environment will continue to increase. Furthermore, the gradual elimination of fee-for-service care in favor of bundled payments will place additional risk on providers to prevent costly complications. In the USA, the American Society of Anesthesiologists has offered the 'surgical home' as a new model for perioperative care delivery in which the anesthesiologist serves as the coordinator of care from the preoperative through the postoperative phase. The purpose is not only to increase patient-centeredness but also to find opportunities for cost savings and increased efficiencies. SUMMARY: Global demographic and health policy trends are calling for new models of healthcare delivery. Anesthesiologists have much experience in the fields of risk assessment and quality improvement. They are well positioned to become leaders in the perioperative care environment of the future.