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Anesthesia Drives Up Colonoscopy Costs

Anesthesia providers who deliver sedation to low-risk patients during colonoscopies needlessly drive up the screening procedure's annual costs by as much as $1.1 billion, according to a study in the Journal of the American Medical Association.

Researchers at the Santa Monica, Calif.-based Rand Corporation say the use of anesthesia providers during GI procedures more than doubled between 2003 and 2009, even though no clinical evidence has shown that a majority of patients were sick enough to justify the extra expense. About two-thirds of the anesthesia services delivered during the study period were to low-risk patients (identified as physical status class 1 or 2 based on the American Society of Anesthesiologists' risk scale), according to the report.

The use of anesthesia providers was 4 times more common in the northeast than in the west, say the researchers, who note that payments for GI anesthesia services doubled in Medicare cases and quadrupled in commercially insured procedures over the study period.

"The nation's health system is under pressure to reduce low-value health care in order to curb the rapid overall rise in healthcare costs," says Soeren Mattke, DSc and MPH, the study's senior author and a senior scientist at Rand. "If we cannot eliminate healthcare spending that provides little or no value, we risk facing spending cuts that could deprive patients of needed care."

Daniel Cook

Frontline Healthcare Workers Slow to Get Seasonal Flu Shots

Healthcare workers are far more likely to get seasonal flu vaccinations if they believe the shots are effective, than if they're reminded that the shots help to safeguard patients against infection risks, a new study suggests.

Investigators reviewing 13 studies that included nearly 85,000 healthcare workers in North America, Europe and Australia also found that doctors were more willing than nurses to get a seasonal flu shot.

Researchers identified several other factors that most influence healthcare workers' decisions to get a flu shot, including a person's willingness to prevent the flu virus from spreading, belief that the flu is highly contagious, having a family that is typically vaccinated and having convenient access to vaccination.

Conversely, study authors found a willingness to protect themselves or patients at risk of complications associated with catching the flu, prior experience with the virus, coming in contact with children or having direct patient contact did little to motivate healthcare workers to get vaccinated.

"Influenza vaccination will only be successful in [healthcare workers] if they are properly educated and if the vaccine is easily accessible," say researchers.

Mark McGraw

Take Action Against Insurers' Denials

No matter how much revenue your facility loses to delayed, denied or underpaid claims, it's too much. But you're not powerless in your dealings with insurance carriers who are holding your revenues hostage. In a recent issue of Outpatient Surgery Magazine, a panel of coding and billing specialists examined the most frequently cited difficulties business staffers face in dealing with insurers and detailed the steps they can take to resolve their reimbursement issues.

David Bernard

InstaPoll: Are Your Surgeons' Preference Cards Up to Date?

Few things are more inefficient or costlier than opening instruments for a surgeon only to see them go unused during the procedure. Tell us in this week's InstaPoll how accurate your surgeons' preference cards are.

Last week we asked if you let parents into your PACU to see their child emerge from anesthesia. The results, based on 358 responses, were widely split:

  • always: 16%

  • sometimes: 41%

  • never: 43%

    Dan O'Connor

  • News & Notes
  • Double-gloving benefits studied Surgical personnel who wear 2 layers of gloves see blood on their hands after surgery less often than those who wear a single pair, says a study of gloving behavior in the March AORN Journal, leading researchers to conclude that double-gloving offers some protection against needlesticks. They also found that those who wear darker gloves as breach indicators beneath lighter gloves tend to change their gloves during surgery more often than those who wear two pair of the same color.

  • Sleep apnea surgery is safe Complication rates following multi-level sleep apnea surgery are exceedingly low, according to an Archives of Otolaryngology-Head and Neck Surgery study. Out of 487 surgical patients with obstructive sleep apnea who underwent surgery between 2007 and 2010, only 1 patient had an airway obstruction, say the researchers, who note that the overall complication rate was 7.1%. They say routinely admitting all OSA patients to the intensive care unit after surgery is unnecessary. "These patients should be closely monitored in PACU," they conclude, "and based on the outcome of this period, they can be observed overnight in either the high-dependency unit or the general ward."

  • Comparing hernia repair techniques Total extraperitoneal inguinal hernioplasty was associated with higher patient satisfaction, less chronic pain and less impairment of groin sensation when compared to the open surgical Lichtenstein repair, according to a study conducted by Dutch researchers.