Cost-effectiveness of preoperative examinations
(1997) Belgian-Society-of-Internal-Medicine Symposium on Peri-Operative Care — Location: BRUSSELS (Belgium)
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- Abstract
- Preoperative medical evaluation is needed to assess individual patients risks of perioperative morbidity and mortality. The content of the preoperative examination remains the object of discussion. Although a well documented preoperative assessment of a patient's health status might allow to optimise his condition before surgery and to plan the most appropriate perioperative management, leading to an improvement of perioperative outcome as well as a reduction in costs, data to support this claim are still most often indirect. A large number of patients remain asymptomatic, with normal tests, which raises questions about the appropriateness to request a battery of tests on every candidate to surgery. Patients risks should be assessed mainly by history and physical examination, which might reduce drastically preoperative indication of laboratory tests : age, operation site, preoperative diseases and emergent surgery are important factors to consider. A risk estimate is presented, as well as recommendations for a preoperative health assessment, by categories of patients, following a screening pathway. Costs have been estimated in various alternatives. They have been evaluated to be above 2 billion BEF per year in Belgium for 563,485 surgical cases, and could most likely be reduced by about 60% in a near future.
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Citations
Roger France, F., & Lefebvre, C. (1997). Cost-effectiveness of preoperative examinations. Acta Clinica Belgica (Multilingual Edition), 52(5), 275-286. https://doi.org/10.1080/17843286.1997.11718589 (Original work published 1997)