Preoperative spirometry and laparotomy: blowing away dollars

Chest
L A De NinoC P Page

Abstract

Increasing evidence indicates that routine preoperative diagnostic spirometry (pulmonary function tests [PFTs]) before elective abdominal surgery does not predict individual risk of postoperative pulmonary complications and is overutilized. This economic evaluation estimates potential savings from reduced use of preoperative PFTs. Analyses of (1) real costs (resource consumption to perform tests) and (2) reimbursements (expenditures for charges) by third-party payers. University-affiliated public and Veterans Affairs hospitals. Adults undergoing elective abdominal operations. Average real cost of PFTs was $19.07 (95% confidence interval [CI], $18.53 to $19.61), based on a time and motion study. Average reimbursement expenditure by third-party payers for PFTs was $85 (range, $33 to $150; 95% CI, $68 to $103), based on Medicare payment of $52 and a survey of nine urban US hospitals with a spectrum of bed sizes and teaching status. Estimates from published literature included the following: (1) annual number of major abdominal operations, 3.5 million; and (2) proportion of PFTs not meeting current guidelines, 39% (95% CI, 0.31 to 0.47). Local data were used when estimates were not available in the literature: (1) proportion of lap...Continue Reading

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Citations

Feb 24, 2005·Der Anaesthesist·M M Berger, R Gust
Feb 2, 2010·Clinics in Colon and Rectal Surgery·David P Parsons
Jun 8, 1999·Plastic and Reconstructive Surgery·D A JansenB D Nossaman
Oct 19, 2011·La Presse médicale·Jean-Marc Delay, Samir Jaber
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Aug 3, 2013·The Journal of International Medical Research·Jin HuhDuk-Kyung Kim
Sep 22, 2001·The Medical Clinics of North America·E Trayner, B R Celli

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