Health Care Costs and the Perioperative Surgical Home

Abstract

The perceptions of anesthesiologists of US health care finance reform are germane to informing the future of our specialty. For this reason, we sought to assess anesthesiologists' views of their own importance in cost-reduction strategies. In addition, respondents were asked a series of questions related to the Perioperative Surgical Home. A cross-sectional survey was sent through email to 6000 randomly chosen active members of the American Society of Anesthesiologists. Respondents were asked to indicate what level of responsibility they perceive stakeholders to have in reducing the cost of health care and perioperative care delivery. Respondents were then asked to describe their relative enthusiasm for cost-reduction strategies. To validate the primary outcome, we took advantage of the American Society of Anesthesiologists' recent focus on the Perioperative Surgical Home to ask a series of related questions as comparators. Thirty-eight percent (95% confidence interval, 35-42) of respondents indicated that physicians bear "major responsibility" for cost reduction, 58% (55-61) indicated that physicians bear "some responsibility," and 4%, only a small fraction (0.7-7.5) indicated that physicians bear "no responsibility." Respondents also indicated that other entities listed bear "major responsibility" for cost reduction including hospitals (57% [54-61]) and insurance companies (54% [51-57]). Comparator data from questions not designed to directly measure the primary outcome are reported, including questions about the Perioperative Surgical Home. US anesthesiologists surveyed perceive other stakeholders, such as hospitals and insurance companies, as having a major responsibility in cost reduction. Furthermore, they are not enthusiastic about substantial financial reform such as cuts to Medicare payments.