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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Selective ordering of preoperative investigations by anesthesiologists reduces the number and cost of tests: La demande selective de tests preoperatoires par les anesthesiologistes reduit le nombre et le cout des tests.
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Selective ordering of preoperative investigations by anesthesiologists reduces the number and cost of tests: La demande selective de tests preoperatoires par les anesthesiologistes reduit le nombre et le cout des tests.

机译：麻醉师对术前检查的选择性排序减少了测试的数量和成本：术前选择性麻醉师要求麻醉师对试验进行进一步的分类。

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PURPOSE: Preoperative investigations are frequently ordered according to care maps or protocols. We hypothesized that selective ordering of investigations by anesthesiology staff would reduce the number and cost of testing. METHODS: Prospective descriptive double cohort study carried out over 17 weeks in a tertiary care preadmission clinic. In Group 1, testing followed usual practice (based on standing preoperative orders) while in Group 2 testing was initiated only on the order of an attending anesthesiologist or anesthesiology resident. Postoperative complications were categorized and confirmed by an internist blinded to group assignment. Fisher's exact test, Chi-square and Student's t test were used to compare the groups as appropriate. Statistical significance was inferred at P < 0.05. RESULTS: Data were obtained from 507 patients in Group 1 and 431 patients in Group 2. Demographics and ASA risk score were similar in both groups. The mean number of tests ordered did not differ between groups. The mean cost of investigations was reduced from Dollars 124 in Group 1 to Dollars 95 in Group 2 (P < 0.05). If data for patients assessed by staff anesthesiologists only were considered, the mean cost of testing was reduced to Dollars 73. The number and cost of tests ordered by anesthesia residents were similar to that in Group 1. More complications were noted in Group 2, but these did not appear to be related to the altered test ordering practice. CONCLUSION: Selective test ordering by staff anesthesiologists reduces the number and cost of preoperative investigations. Educational efforts should be directed towards improving resident and staff preoperative test ordering practices.
机译：目的：术前检查通常根据护理图或协议进行。我们假设麻醉医生对研究进行有选择的排序会减少测试的数量和成本。方法：前瞻性描述性双队列研究在三级护理入院前诊所进行了17周。在第1组中，测试遵循常规操作（基于术前常规），而在第2组中，仅根据主治麻醉医师或麻醉医师的要求开始测试。术后并发症归类并由对小组分配不知情的内科医生确认。费舍尔精确检验，卡方检验和学生t检验用于比较适当的组。统计学显着性推断为P <0.05。结果：数据来自第1组的507例患者和第2组的431例患者。两组的人口统计学和ASA风险评分相似。两组之间订购的平均测试次数没有差异。平均调查成本从第1组的124美元降低到第2组的95美元（P <0.05）。如果仅考虑由工作人员麻醉师评估的患者数据，则平均检查成本将降低至73美元。麻醉住院医师订购的检查的次数和费用与第1组相似。在第2组中发现更多的并发症，但这些似乎与更改后的测试订购惯例无关。结论：由麻醉师进行的选择性测试订购减少了术前检查的数量和成本。教育工作应针对改善住院医师和工作人员术前测试订购的习惯。

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