AANA publishes new study on safety outcomes, cost-effectiveness of anesthesia delivery

Reviewed by James Ives, M.Psych. (Editor)Oct 29 2019

The American Association of Nurse Anesthetists (AANA) released a new study that suggests politics and professional interests are the main drivers of anesthesia policy in the United States.

In their study, "Advocacy, Research, and Anesthesia Practice Models: Key Studies of Safety and Cost-Effectiveness" first published in Policy, Politics & Nursing Practice, researchers contend that while data shows low risk of death and complications associated with anesthesia, there is debate among professional societies and policymakers about which anesthesia professionals deliver safer care.

We sought to review and critique studies of the safety outcomes and cost-effectiveness of anesthesia delivery that have been cited in the Federal Trade Commission (FTC) comment letters related to competition in healthcare and laid out how each profession interprets their position in the market for anesthesia services."

Lorraine Jordan, PhD, CRNA, CAE, AANA chief advocacy officer

"The FTC has a role in protecting consumers from anticompetitive conduct," said Jordan. "That is why it is important to evaluate how evidence is used to make claims about quality and cost in healthcare."

The practice of anesthesia includes multiple competing models, including services delivered by anesthesiologists, independent practice by Certified Registered Nurse Anesthetists (CRNAs), and team-based approaches incorporating anesthesiologist supervision or direction of CRNAs.

The researchers 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."

The AANA has remained deeply committed to ensuring that "all patients across the country have access to high-quality anesthesia care, and CRNAs are a big part of that process," said Kate Jansky, MHS, CRNA, APRN, USA LTC (ret), AANA president.

"Published research shows no difference in outcomes of care with physician supervision, and the increase in cost for unnecessary supervision is borne by patients and facilities," said Jansky.

As part of an executive order aimed at protecting and improving Medicare, the Secretary of Health and Human Services has been charged with proposing a regulation that would eliminate burdensome regulatory requirements, remove costly and needless physician supervision requirements, and all other licensure requirements of the Medicare program that limit physicians and non-physicians from practicing at full scope.

"We are pleased to see that our voices are being heard and for the continued advancement of CRNAs," said Randall D. Moore, DNP, MBA, CRNA, chief executive officer of the AANA. "Access to high-quality anesthesia care and safety are paramount in our great profession."

AANA's research was funded in part by the Minnesota Association of Nurse Anesthetists in support of the AANA Foundation. Released in September, the study includes a history of anesthesia professionals, a cost-efficiency and reimbursement backgrounder, views on safety in practice, and a critical look at evidence.