Surgical specialty and preoperative medical consultation based on commercial health insurance claims

Perioperative Medicine
Stephan R ThilenMiriam M Treggiari

Abstract

Surgical patients are sometimes referred for preoperative evaluations by consultants in other medical specialties, although consultations are unnecessary for many patients, particularly for healthy patients undergoing low-risk surgeries. Surgical specialty has been shown to predict usage of preoperative consultations. However, evidence is generally limited regarding factors associated with preoperative consultations. This study evaluates surgical specialty and other predictors of preoperative consultations. This retrospective cohort study analyzed surgery claims of 7400 privately insured patients in Washington, United States, from eight surgical specialties. We estimated log-Poisson generalized estimating equation models that regress whether a patient received a consultation on surgical specialty and covariates accounting for the data's hierarchical structure with patients nesting within surgeons, and surgeons nesting within provider organizations. Covariates include age, gender, Deyo comorbidity index, surgical risk, and geographic factors. Overall, 485 (6.6%) patients had a preoperative consultation. The incidence of preoperative consultation varied significantly by surgical specialty. Orthopedics, neurosurgery, and ophthalmo...Continue Reading

References

Jun 1, 1992·Journal of Clinical Epidemiology·R A DeyoM A Ciol
May 15, 1998·JAMA : the Journal of the American Medical Association·R A RosenblattR Schneeweiss
Jan 31, 2002·Anesthesiology·UNKNOWN American Society of Anesthesiologists Task Force on Preanesthesia Evaluation
Aug 17, 2005·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Robert I KatzStephen A Vitkun
Nov 28, 2007·Archives of Internal Medicine·Andrew D AuerbachJudith Maselli
Jan 23, 2008·BMC Family Practice·Lisa PausjenssenSharon E Card
Aug 11, 2010·Archives of Internal Medicine·Duminda N WijeysunderaAndreas Laupacis
Mar 19, 2013·Anesthesiology·Stephan R ThilenMiriam M Treggiari
Dec 25, 2013·JAMA Internal Medicine·Stephan R ThilenDuminda N Wijeysundera

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