ArticleJournal of anesthesia, analgesia and critical care2024
Value-based preoperative assessment in a large academic hospital.
Article in Journal of anesthesia, analgesia and critical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
5 citing papers in PubMed.
- Reducing unnecessary preoperative testing in Day Surgery: a Choosing Wisely-based quality improvement study.Journal of anesthesia, analgesia and critical care · 2026Article
- Value-based outsourcing is associated with better environmental and economic sustainability metrics while maintaining patient safety: a comparative analysis of electricity use, water use, and prescription costs in public hospitals of Madrid (Spain).Frontiers in health services · 2026Article
- Considerations for Care of the Cancer Patient.International anesthesiology clinics · 2025Article
- Correction: Value-based preoperative assessment in a large academic hospital.Journal of anesthesia, analgesia and critical care · 2024Article
- Value-based care as a solution to resolve the open debate on public healthcare outsourcing in Europe: What do the available data say?Frontiers in public health · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
27 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundValue-based healthcare (VBHC) is an approach that focuses on delivering the highest possible value for patients while driving cost efficiency in health services. It emphasizes improving patient outcomes and experiences while optimizing the use of resources, shifting the healthcare system's focus from the volume of services to the value delivered. Our study assessed the effectiveness of implementing a VBHC-principled, tailored preoperative evaluation in enhancing patient care and outcomes, as well as reducing healthcare costs.
methodsWe employed a quality improvement, before-and-after approach to assessing the effects of implementing VBHC strategies on the restructuring of the preoperative evaluation clinics at Humanitas Research Hospital. The intervention introduced a VBHC-tailored risk matrix during the postintervention phase (year 2021), and the results were compared with those of the preintervention phase (2019). The primary study outcome was the difference in the number of preoperative tests and visits at baseline and after the VBHC approach. Secondary outcomes were patient outcomes and costs.
resultsA total of 9722 patients were included: 5242 during 2019 (baseline) and 4,480 during 2021 (VBHC approach). The median age of the population was 63 (IQR 51-72), 23% of patients were classified as ASA 3 and 4, and 26.8% (2,955 cases) were day surgery cases. We found a considerable decrease in the number of preoperative tests ordered for each patient [6.2 (2.5) vs 5.3 (2.6) tests, p < 0.001]. The number of preoperative chest X-ray, electrocardiogram, and cardiac exams decreased significantly with VBHC. The length of the preoperative evaluation was significantly shorter with VBHC [373 (136) vs 290 (157) min, p < 0.001]. Cost analysis demonstrated a significant reduction in costs, while there was no difference in clinical outcomes.
conclusionsWe demonstrated the feasibility, safety, and cost-effectiveness of a tailored approach for preoperative evaluation. The implementation of VBHC enhanced value, as evidenced by decreased patient time in preoperative evaluation and by a reduction in unnecessary preoperative tests.
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