When Do Anesthesiologists Delegate?

  title={When Do Anesthesiologists Delegate?},
  author={Margo L. Rosenbach and J Cromwell},
  journal={Medical Care},
Nurse anesthetists (CRNAs) are a lower cost substitute for anesthesiologists in the delivery of anesthesia services. This article addresses the question of when anesthesiologists delegate in a team approach as opposed to using a solo arrangement. Logistic regression analysis was done using data from the 1986 Anesthesia Practice Survey and revealed that the team approach is more likely in areas with a relatively large supply of CRNAs; in hospitals with large surgical volumes, teaching facilities… Expand
Perceptions by an anesthesia care team on the need for medical direction.
Anesthesiologists and nurse anesthetists in this study agreed in their perceptions that more than 70% of these cases did not need medical direction, and a predictive equation was constructed for cases where providers perceived that medical direction was beneficial. Expand
Advocacy, Research, and Anesthesia Practice Models: Key Studies of Safety and Cost-Effectiveness
It is argued that while research in this area is imperfect, the strong safety record of anesthesia in general and CRNAs in particular suggest that politics and professional interests are the main drivers of supervision policy in anesthesia delivery. Expand
CRNA (certified registered nurse anesthetist) manpower forecasts: 1990-2010.
A CRNA manpower forecasting model is developed in this article that shows CRNA supply and requirements from 1990 through 2010 and suggests that more than a twofold increase in CRNA school enrollments is needed just to fill conservative baseline needs given the predicted growth in operations in all settings. Expand
Is Physician Anesthesia Cost-Effective?
Economic evidence is offered in support of the physician anesthesia model of care with reference case results suggesting that physician anesthesia is cost saving with an estimated incremental cost-effectiveness ratio of −$2,601/YLS for a younger privately insured patient and an estimated cost- effectiveness ratio of +$4,410/Y LS for an elderly Medicare insured patient. Expand
A Model of Hierarchical Professionals: Cooperation and Conflict between Anesthesiologists and CRNAs
A model where the supply of MDAs endogenously determines the earnings of CRNAs and MDAs, and the extent of supervision ofCRNAs by MDAs is developed, which can be applied to the analysis of relationships between other hierarchical professionals with overlapping responsibilities, such as nurse practitioners and primary care physicians. Expand
Cooperation and conflict between very similar occupations: the case of anesthesia
It is found that both the earnings, and the likelihood of medical supervision of CRNAs, are closely determined by their market share. Expand
Anesthesia Providers, Patient Outcomes, and Costs
A comparison of different third-party reimbursement practices and contractual and employment in anesthesia services provided in health care facilities in Minnesota is compared. Expand
Con: All elective coronary artery bypass grafting patients are not American Society of Anesthesiologists' Physical Status IV.
  • R. Wiklund
  • Medicine
  • Journal of cardiothoracic and vascular anesthesia
  • 1999
Although MI is still the leading cause of sudden death in the United States, the feeling of gloom and doom surrounding this event is slowly being replaced by a sense of optimism, especially if the patient with acute myocardial ischemia has early access to hospital care. Expand
Frustrated wants and entitlements: fundamental components of CRNA job satisfaction.
Results indicate the importance of CRNA frustrated wants and CRNA perceived entitlements as key factors contributing to CRNA job satisfaction above and beyond the three background variables studied. Expand


Characteristics of Nurse Anesthetists Working With and Without Anesthesiologists
A consultation network supported by telecommunications deserves consideration as a means of providing CRNAs who work independently in small rural hospitals with a cost-effective team approach to anesthesia care. Expand
A study of the deaths associated with anesthesia and surgery: based on a study of 599, 548 anesthesias in ten institutions 1948-1952, inclusive.
The death rate (and why deaths occurred) attributable to anesthesia whether due to agent or technique or to their misapplications is determined and the responsibility of the anesthetist in the total care of the surgical patient when failure occurred is assessed. Expand
The role of anesthesia in surgical mortality.
The role of anesthesia in contributing to surgical mortality has been studied in 33,224 patients given either spinal anesthesia or a general anesthetic to which muscle relaxants were added, and when deaths were related to the use of muscle relaxant, errors of omission or commission were always apparent. Expand
The Baltimore Anesthesia Study Committee. Review of 1,024 postoperative deaths.
A study of 1,024 postoperative deaths in Baltimore hospitals during a period of 5 1/2 years (1953 to 1959) indicated that anesthesia was the principal cause of death in 6.3% of the cases and aExpand