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Preoperative Anesthesiology Consult Utilization in Ontario -- A Population-Based Study
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  • Joanna Dion,
  • Robert Campbell,
  • Paul Nguyen,
  • Jason Beyea
Joanna Dion
Queen's University
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Robert Campbell
Queen's University
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Paul Nguyen
Queen's University
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Jason Beyea
Queen's University
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Abstract

ABSTRACT ¬ Rationale, aims and objectives: Physician consultations are a limited resource. Anesthesiologists provide anesthesia during surgery and procedures, prepare patients for surgery in preoperative clinics, and provide postoperative care. This study sought to evaluate current consultation usage patterns, with an aim to determine possible opportunities for efficiency. Method: A retrospective comprehensive population-based cohort study was performed, evaluating all hospitals in the Canadian province of Ontario from 2002-2018. The main outcome measures were American Society of Anesthesiologists (ASA) classification of the patients, and whether the patients underwent surgery within 3 months following the anesthesia consultation. Results: A cohort of 2,023,499 patients, and a total of 2,920,100 preoperative anesthesia consultations was obtained. The number of consults per year doubled between 2003 (112,983/year) and 2017 (246,427/year). Each year, an average of 19.32% of the consults (range: 17.69-20.49%) were for patients that did not progress to having surgery. Of those that did have surgery following the anesthesia consult, 37.23% were ASA Classification I or II. The most common surgical procedures (percent of total) following anesthesia consult were: Knee implantation of internal device (9.46%), hip implantation of internal device (5.84%), cataract excision (4.09%), repair of muscle of chest/abdomen (3.31%), uterus excision (2.76%), and gallbladder excision (2.67%). Conclusions: This study reveals data on utilization and trends over time of preoperative anesthesia consultations. Potential opportunities for optimization were found, including patients who did not proceed to surgery, and healthier patients undergoing low to moderate risk surgery that may not require consultation.

Peer review status:IN REVISION

17 Sep 2020Submitted to Journal of Evaluation in Clinical Practice
06 Oct 2020Submission Checks Completed
06 Oct 2020Assigned to Editor
11 Oct 2020Review(s) Completed, Editorial Evaluation Pending
11 Oct 2020Reviewer(s) Assigned
02 Nov 2020Editorial Decision: Revise Major
17 Dec 20201st Revision Received
21 Dec 2020Assigned to Editor
21 Dec 2020Submission Checks Completed
04 Jan 2021Reviewer(s) Assigned
31 Jan 2021Review(s) Completed, Editorial Evaluation Pending
01 Feb 2021Editorial Decision: Revise Major
12 May 20212nd Revision Received
13 May 2021Assigned to Editor
13 May 2021Submission Checks Completed
16 May 2021Editorial Decision: Revise Minor
09 Jun 20213rd Revision Received