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 21 May 2018

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News

Increased anesthesia service use during outpatient gastroenterology procedures 

Anesthesia service use during outpatient gastroenterology procedures continued to increase, and potentially discretionary spending remained high, reports the latest issue of the American Journal of Gastroenterology.

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Previous studies have identified an increasing number of gastroenterology (GI) procedures using anesthesia services to provide sedation, with a majority of these services delivered to low-risk patients. 

Dr Hangsheng Liu and colleagues from Massachusetts updated these trends with the most recent years of data.

The research team used Medicare and commercial claims data from 2010 to 2013 to identify GI procedures and anesthesia services based on CPT codes, which were linked together using patient identifiers and dates of service. 

The researchers defined low-risk patients as those who were classified as ASA (American Society of Anesthesiologists) physical status class I or II. 

For those patients without an ASA class listed on the claim, we used a prediction algorithm to impute an ASA physical status.

GI procedures involving anesthesia service accounted for 48% in 2013
American Journal of Gastroenterology
The researchers reported that over 6.6 million patients in their sample had a GI procedure between 2010 and 2013. 

GI procedures involving anesthesia service accounted for 34% in 2010, and 48% in 2013 in Medicare patients, and 38% in 2010 and 53% in 2013 in commercially insured patients. 

The team reported that as more patients used anesthesia services, total anesthesia service use in low-risk patients increased 14%, from 27,191 to 33,181 per million Medicare enrollees. 

Similarly, the research team observed a nearly identical uptick in commercially insured patients from 15,871 to 22,247 per million, an increase of almost 15%. 

During 2010–2013, spending associated with anesthesia services in low-risk patients increased from US$3.14 million to US$3.45 million per million Medicare enrollees, and from US$7.69 million to US$10.66 million per million commercially insured patients.

Dr Liu's team concludes, "During 2010 to 2013, anesthesia service use in GI procedures continued to increase, and the proportion of these services rendered for low-risk patients remained high."

Am J Gastroenterol 2017; 112:297–302
21 February 2017

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