Key result
Opting out of the requirement for physician oversight of certified registered nurse anesthetists did not result in increased inpatient deaths or complications.
Why the study?
Does allowing certified registered nurse anesthetists to work without physician supervision increase inpatient deaths or complications in Medicare patients?
Observational
Yes
Does allowing certified registered nurse anesthetists to work without physician supervision increase inpatient deaths or complications in Medicare patients?
Allowing certified registered nurse anesthetists to work without physician supervision does not increase inpatient deaths or complications among Medicare patients.
Answers are grounded in this paper and cite their sources.
Supports expanded CRNA autonomy in Medicare settings without safety signal; leaves open need for randomized confirmation.
In 2001 the Centers for Medicare and Medicaid Services (CMS) allowed states to opt out of the requirement for reimbursement that a surgeon or anesthesiologist oversee the provision of anesthesia by certified registered nurse anesthetists. By 2005, fourteen states had exercised this option. An analysis of Medicare data for 1999-2005 finds no evidence that opting out of the oversight requirement resulted in increased inpatient deaths or complications. Based on our findings, we recommend that CMS allow certified registered nurse anesthetists in every state to work without the supervision of a surgeon or anesthesiologist.
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Dulisse et al. (2010) conducted an observational in Inpatient anesthesia. Opting out of physician oversight for certified registered nurse anesthetists vs. States requiring physician oversight was evaluated on Inpatient deaths or complications. Opting out of the requirement for physician oversight of certified registered nurse anesthetists did not result in increased inpatient deaths or complications.
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