Preoperative Blood Tests in Elective General Surgery: Cost and Clinical Implications

Phoenix, Gokulan; Elliott, Tamara; Chan, James; Das, Saroj

doi:10.1177/175045891202200902

Cited by 8 publications

(3 citation statements)

References 22 publications

(42 reference statements)

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“…Similarly, in a study of 1496 patients in Thailand, Siriussawakul et al found that only 12.1% of patients had preoperative workups that were in accordance with guidelines, with CMP/electrolytes being the most commonly ordered unnecessary test ( 26 ). In the UK, Phoenix et al estimated that inappropriate preoperative blood work resulted in an extrapolated cost of £11.2 million per year ( 28 ). In the United States, a similar trend is noted.…”

Section: Discussionmentioning

confidence: 99%

Variation in Practice of the Diagnostic Workup of Asymptomatic Patients Diagnosed with Invasive Breast Cancer

et al. 2016

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IntroductionBreast cancer is frequently diagnosed, yet variation remains in terms of practice patterns in presurgical workup. We sought to determine factors associated with this variation.MethodsAn anonymous web-based survey was distributed to surgeons regarding their practices. Statistical analyses were conducted using SPSS.ResultsA total of 253 surgeons responded to the survey. 17.0% were in academic practice, 37.5% were hospital employed, and 41.5% were in private practice. 53.3% claimed that >50% of their practice was breast related. Surgeons were asked how often they would use various tests in the workup of an otherwise healthy asymptomatic patients, presenting with a non-palpable mammographic abnormality and a core needle biopsy showing invasive breast cancer. 23.5% stated that they always would obtain a breast ultrasound, 17.2% stated that they never would. 12.8% stated that they never order a breast MRI; 4.1% always would. Workup of patients did not vary significantly based on number of years in practice nor practice setting. However, those whose practice was >50% breast were more likely to state that they would always order a breast ultrasound (32.5 vs. 12.9%, p < 0.001), and less likely to state that they would never order a breast MRI (3.4 vs. 25.8%, p < 0.001). However, the proportions of surgeons who would always order a breast MRI were similar in the two groups (3.4 and 3.2%, respectively).ConclusionThese data highlight the lack of uniformity in the workup of asymptomatic patients presenting with non-palpable breast cancers, pointing to potential areas for improving value by minimizing variability.

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Section: Discussionmentioning

confidence: 99%

Variation in Practice of the Diagnostic Workup of Asymptomatic Patients Diagnosed with Invasive Breast Cancer

et al. 2016

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“…Diferentes autores y guías clínicas [82][83][84][85][86][87] advierten y establecen recomendaciones en contra de la solicitud de pruebas analíticas prequirúrgicas de manera rutinaria, recomendando en su lugar realizar una buena historia clínica en el estudio prequirúrgico, y solicitando aquellas pruebas necesarias individualizando en función de las características del paciente, así como de la intervención. Fundamentan este hecho en la baja probabilidad de que exista alguna enfermedad no diagnosticada que comprometa el periodo perioperatorio en pacientes clínicamente asintomáticos.…”

Section: Solicitud De Pruebas Analíticas En El Preoperatoriounclassified

Conceptos básicos para la solicitud e interpretación de analíticas en Podología.

Iglesias¹

2019

Rev. Esp. Pod.

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“…Mostly these tests are requested without specific indication based on history or physical examination but rather on speculations that the anaesthetist may "require them" to proceed with the surgery and thus avoid delays and cancellations Routine pre-operative test results in significant cost to the hospital and expense for the patient. The cost of a single laboratory test may be negligible but too many tests have increased cost for many national health schemes [8] [9]. An unnecessary preoperative investigation adds a lot of cost to both the patient and insurance schemes, some of these laboratory investigations are not covered under the health insurance scheme thereby adding to the cost of surgery even if the patient is insured.…”

Section: Introductionmentioning

confidence: 99%

Routine Preoperative Laboratory Testing: Economic Burden on Pre-Surgical Patients

Obasuyi¹,

Antwi-Kusi²

2017

OJAnes

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Background: Routine pre-operative test, results in significant cost to the hospital and expense for the patient. The cost of a single laboratory test may be negligible but too many tests have increased cost for many national health schemes. Most of these patients cannot afford this extra cost thereby delaying surgery and adding up to emergencies. Implementation of change is necessary to reduce economic burden on the patient and enhance patient care. The aim of this study was to determine the economic burden of preoperative laboratory tests on pre-surgical patients in Komfo Anokye Teaching Hospital with a view to making appropriate recommendations that will reduce costs for the patients. Methodology: This was a prospective, cross-sectional study of patients undergoing elective surgery at K.A.T.H from 1 st to 31 st March 2014. A quantitative technique was used to effectively quantify laboratory results that were contained in a patient's folder before an elective surgical procedure. Close and open ended questionnaire was developed and answered by reviewing patient's folders during the pre-anaesthesia assessment. Cost of various laboratory investigations was obtained on request from one private laboratory and the KATH main laboratory. Data were analyzed using Statistical Package of Social Sciences (SSPS) version 22 and Microsoft Excel 2010. Results: The total cost of preoperative laboratory investigations in the study population was GHC 15, 321.19 (GHC 92.85 per individual); and for tests that were not indicated, GHC 3, 266.83 (GHC19.80 per individual). Conclusion: Routine preoperative laboratory tests ordered by Surgeons in Komfo Anokye Teaching Hospital impose an economic burden on the patients. The development of a comprehensive guideline that will help in the ordering of preoperative laboratory investigation will reduce costs for the patients.

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Preoperative Blood Tests in Elective General Surgery: Cost and Clinical Implications

Cited by 8 publications

References 22 publications

Variation in Practice of the Diagnostic Workup of Asymptomatic Patients Diagnosed with Invasive Breast Cancer

Variation in Practice of the Diagnostic Workup of Asymptomatic Patients Diagnosed with Invasive Breast Cancer

Conceptos básicos para la solicitud e interpretación de analíticas en Podología.

Routine Preoperative Laboratory Testing: Economic Burden on Pre-Surgical Patients

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