Health care institutions in many Western countries have developed preoperative testing and assessment guidelines to improve surgical outcomes and reduce cost of surgical care. The aims of this chapter are to (1) summarize the literature on the effect of preoperative testing on clinical outcomes, efficiency, and cost; and (2) to compare preoperative testing guidelines developed in the United States, the United Kingdom, and Canada.
We reviewed the literature from 1975 to 2014 for studies and preoperative testing guidelines.
We identified 29 empirical studies and 8 country-specific guidelines for review. Most studies indicate that preoperative testing is overused and comes at a high cost. Guidelines are tied to payment only in one country studied. This is the most recent review of the literature on preoperative testing and assessment with a focus on quality of care, efficiency, and cost outcomes. In addition, this chapter provides an international comparison of preoperative guidelines.
The preparation of this chapter is based upon work supported by the National Science Foundation (NSF) under Grant No. IIP-0832439. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. Further, this project was co-funded by NSF’s Center for Health Organization Transformation’s industry members, including the American Society of Anesthesiologists.
Kash, B.A., Cline, K.M., Timmons, S., Roopani, R. and Miller, T.R. (2015), "International Comparison of Preoperative Testing and Assessment Protocols and Best Practices to Reduce Surgical Care Costs: A Systematic Literature Review", International Best Practices in Health Care Management (Advances in Health Care Management, Vol. 17), Emerald Group Publishing Limited, Bingley, pp. 161-194. https://doi.org/10.1108/S1474-823120140000017010
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