دورية أكاديمية
Cost-Effectiveness Research in Anesthesiology.
| العنوان: | Cost-Effectiveness Research in Anesthesiology. |
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| المؤلفون: | Teja BJ; From the Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts., Sutherland TN; Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts., Barnett SR; From the Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts., Talmor DS; From the Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts. |
| المصدر: | Anesthesia and analgesia [Anesth Analg] 2018 Nov; Vol. 127 (5), pp. 1196-1201. |
| نوع المنشور: | Journal Article; Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1310650 Publication Model: Print Cited Medium: Internet ISSN: 1526-7598 (Electronic) Linking ISSN: 00032999 NLM ISO Abbreviation: Anesth Analg |
| أسماء مطبوعة: | Publication: 1998- : Baltimore, Md. : Lippincott Williams & Wilkins Original Publication: Cleveland, International Anesthesia Research Society. |
| مواضيع طبية MeSH: | Health Care Costs*, Anesthesiology/*economics , Perioperative Care/*economics , Postoperative Complications/*economics , Surgical Procedures, Operative/*economics, Anesthesiology/methods ; Animals ; Blood Transfusion/economics ; Comparative Effectiveness Research ; Cost Savings ; Cost-Benefit Analysis ; Humans ; Infection Control/economics ; Patient Care Team/economics ; Postoperative Complications/therapy ; Quality-Adjusted Life Years ; Surgical Procedures, Operative/adverse effects ; Treatment Outcome |
| مستخلص: | Perioperative interventions aimed at decreasing costs and improving outcomes have become increasingly popular in recent years. Anesthesiologists are often faced with a choice among different treatment strategies with little data available on the comparative cost-effectiveness. We performed a systematic review of the English language literature between 1980 and 2014 to identify cost-effectiveness analyses of anesthesiology and perioperative medicine interventions. We excluded interventions related to critical care or pediatric anesthesiology, and articles on interventions not normally ordered or performed by anesthesiologists. Of the >5000 cost-effectiveness analyses published to date, only 28 were applicable to anesthesiology and perioperative medicine and met inclusion criteria. Multidisciplinary interventions were the most cost-effective overall; 8 of 8 interventions were "dominant" (improved outcomes, reduced cost) or cost-effective, including accelerated, standardized perioperative recovery pathways, and perioperative delirium prevention bundles. Intraoperative measures were dominant in 3 of 5 cases, including spinal anesthesia for benign abdominal hysterectomy. With regard to prevention of perioperative infection, methicillin-resistant Staphylococcus aureus (MRSA) decolonization was dominant or cost-effective in 2 of 2 studies. Three studies assessing various antibiotic prophylaxis regimens had mixed results. Autologous blood donation was not found to be cost-effective in 5 of 7 studies, and intraoperative cell salvage therapy was also not cost-effective in 2 of 2 reports. Overall, there remains a paucity of cost-effectiveness literature in anesthesiology, particularly relating to intraoperative interventions and multidisciplinary perioperative interventions. Based on the available studies, multidisciplinary perioperative optimization interventions such as accelerated, standardized perioperative recovery pathways, and perioperative delirium prevention bundles tended to be most cost-effective. Our review demonstrates that there is a need for more rigorous cost-effective analyses in many areas of anesthesiology and that anesthesiologists should continue to lead collaborative, multidisciplinary efforts in perioperative medicine. |
| التعليقات: | Comment in: Anesth Analg. 2018 Nov;127(5):1107-1108. (PMID: 30335657) |
| تواريخ الأحداث: | Date Created: 20180324 Date Completed: 20190819 Latest Revision: 20190819 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1213/ANE.0000000000003334 |
| PMID: | 29570150 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1526-7598 |
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| DOI: | 10.1213/ANE.0000000000003334 |