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Use of anesthesia providers during GI procedures is growing, but may be unnecessary
Date:3/20/2012

Use of anesthesia providers to monitor sedation during screening colonoscopies and other outpatient gastroenterology procedures more than doubled from 2003 to 2009 in the United States, with most of the increase among low-risk patients who may not need this service, according to a new RAND Corporation study.

The findings suggest that as much as $1.1 billion spent annually on anesthesia services for GI-related procedures may not be medically necessary, according to the study published in the March 21 edition of the Journal of the American Medical Association.

Researchers also found substantial regional variation in how often anesthesiologists or nurse anesthetists are used to administer sedation during GI procedures, ranging from 13 percent in the West to 59 percent in the Northeast.

"The use of anesthesia providers during outpatient GI procedures is growing rapidly, although there is no evidence that most patients are sick enough to justify the extra expense," said Dr. Soeren Mattke, the study's senior author and a senior scientist at RAND, a nonprofit research organization. "The growing use of anesthesia providers during GI procedures imposes significant costs on the American health care system at a time when concern is high about the cost of medical care."

Outpatient gastroenterology endoscopy procedures are common among adults in the United States, with more than 20 million procedures performed annually.

Under current treatment guidelines, intravenous sedation during such procedures can be safely administered by the physician doing the procedure, assisted by a nurse, unless the patient is at risk for anesthesia-related complications because of an illness such as advanced heart or lung disease. Anecdotal evidence suggests that anesthesia providers are being used more commonly to administer sedation to low-risk patients, a practice that increases costs while providing little or no benefit to the patient.


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Contact: Warren Robak
robak@rand.org
310-451-6913
RAND Corporation
Source:Eurekalert

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