Anesthesiology clinics
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Geriatric patients are over-represented in hospitalizations, surgeries, and perioperative complications. Special consideration is required for this patient group in the perioperative period because of the prevalence of comorbid diseases, functional impairments, and other deficits. ⋯ Systematic, multidomain assessments should be performed and paired with risk reduction efforts. A shared understanding of patient function and long-term health goals is also important for providing patient-centered care of the geriatric surgical patient.
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Anesthesiology clinics · Dec 2015
ReviewPerioperative Medicine: The Value Proposition for Anesthesia?: A UK Perspective on Delivering Value from Anesthesiology.
Perioperative medicine describes the practice of patient centered, multidisciplinary, and integrated medical care of patients from the moment of contemplation of surgery until full recovery. The value proposition for perioperative medicine rests on defining benefits that outweigh the costs of change. This article discusses the concept of value in the context of healthcare and highlights a number of reasons for relative market failure. Five key opportunities for adding value in the perioperative journey are suggested: collaborative decision-making, lifestyle modification before surgery, standardization of in-hospital perioperative care, achieving full recovery after surgery, and the use of data for quality improvement.
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Ambulatory anesthesia's popularity continues to increase and techniques continue to adapt to the needs of patients. Alterations in existing medications are promising. ⋯ The implementation of the Affordable Health Care Act specifically affects ambulatory settings as the demand and need for patients to undergo screening procedures with anesthesia. The question remains what the best strategy is to meet the needs of our future patients while preserving economic feasibility within an already strained health care system.
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Health care costs continue to increase, and the approach of countries and insurers is to focus on the value of the care delivered. Value is a function of quality in relation to costs. ⋯ The patients' perspectives include out-of-pocket expenses and work lost for both patients and potentially caregivers. The authors provide one example in the area of sleep apnea in which the anesthesiologist can provide value uniquely by being part of the team making the diagnosis.
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Anesthesiology clinics · Dec 2015
ReviewThe Pain Medical Home: A Patient-Centered Medical Home Model of Care for Patients with Chronic Pain.
Chronic pain affects an estimated 100 million people a year in the United States and costs society anywhere from $560 to $635 billion annually. The patient-centered medical home and the patient-centered medical home-neighbor models of care have been advocated to improve patient outcomes. These models of care advocate improved coordination of care within the primary care and specialty care setting. The authors present the patient-centered medical home model of care and suggest how this model of care might be used to improve patient outcomes for patients with chronic pain.