Substantial Increase in Anesthesia Assistance for Outpatient Colonoscopy and Associated Cost Nationwide. Krigel, A., Chen, L., Wright, J. D., & Lebwohl, B. Clinical Gastroenterology and Hepatology, 17(12):2489–2496, November, 2019. ZSCC: 0000019![Substantial Increase in Anesthesia Assistance for Outpatient Colonoscopy and Associated Cost Nationwide [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex Background and Aims The use of anesthesia assistance (AA) for outpatient colonoscopy has been increasing over the past decade, raising concern over its effects on procedure safety, quality, and cost. We performed a nationwide claims-based study to determine regional, patient-related, and facility-related patterns of anesthesia use as well as cost implications of AA for payers. Methods We analyzed the Premier Perspective database to identify patients undergoing outpatient colonoscopy at over 600 acute-care hospitals throughout the United States from 2006 through 2015, with or without AA. We used multivariable analysis to identify factors associated with AA and cost. Results We identified 4,623,218 patients who underwent outpatient colonoscopy. Of these, 1,671,755 (36.2%) had AA; the proportion increased from 16.7% in 2006 to 58.1% in 2015 (P \textless .001). Factors associated with AA included younger age (odds ratios [ORs], compared to patients 18-39 years old: 0.94, 0.82, 0.77, 0.72, and 0.77 for age groups 40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years, respectively); and female sex (OR, 0.96 for male patients compared to female patients; 95% CI, 0.95-0.96). Black patients were less likely to receive AA than white patients (OR, 0.81; 95% CI, 0.81-0.82), although this difference decreased with time. The median cost of outpatient colonoscopy with AA was higher among all payers, ranging from $182.43 (95% CI, $180.80-$184.06) higher for patients with commercial insurance to $232.62 (95% CI, $222.58-$242.67) higher for uninsured patients. Conclusions In an analysis of a database of patients undergoing outpatient colonoscopy throughout the United States, we found that the use of AA during outpatient colonoscopy increased significantly from 2006 through 2015, associated with increased cost for all payers. The increase in anesthesia use mandates evaluation of its safety and effectiveness in colorectal cancer screening programs.
@article{krigel_substantial_2019,
title = {Substantial {Increase} in {Anesthesia} {Assistance} for {Outpatient} {Colonoscopy} and {Associated} {Cost} {Nationwide}},
volume = {17},
issn = {1542-3565},
url = {https://www.sciencedirect.com/science/article/pii/S1542356519300102},
doi = {10/gm5nzj},
abstract = {Background and Aims
The use of anesthesia assistance (AA) for outpatient colonoscopy has been increasing over the past decade, raising concern over its effects on procedure safety, quality, and cost. We performed a nationwide claims-based study to determine regional, patient-related, and facility-related patterns of anesthesia use as well as cost implications of AA for payers.
Methods
We analyzed the Premier Perspective database to identify patients undergoing outpatient colonoscopy at over 600 acute-care hospitals throughout the United States from 2006 through 2015, with or without AA. We used multivariable analysis to identify factors associated with AA and cost.
Results
We identified 4,623,218 patients who underwent outpatient colonoscopy. Of these, 1,671,755 (36.2\%) had AA; the proportion increased from 16.7\% in 2006 to 58.1\% in 2015 (P {\textless} .001). Factors associated with AA included younger age (odds ratios [ORs], compared to patients 18-39 years old: 0.94, 0.82, 0.77, 0.72, and 0.77 for age groups 40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years, respectively); and female sex (OR, 0.96 for male patients compared to female patients; 95\% CI, 0.95-0.96). Black patients were less likely to receive AA than white patients (OR, 0.81; 95\% CI, 0.81-0.82), although this difference decreased with time. The median cost of outpatient colonoscopy with AA was higher among all payers, ranging from \$182.43 (95\% CI, \$180.80-\$184.06) higher for patients with commercial insurance to \$232.62 (95\% CI, \$222.58-\$242.67) higher for uninsured patients.
Conclusions
In an analysis of a database of patients undergoing outpatient colonoscopy throughout the United States, we found that the use of AA during outpatient colonoscopy increased significantly from 2006 through 2015, associated with increased cost for all payers. The increase in anesthesia use mandates evaluation of its safety and effectiveness in colorectal cancer screening programs.},
language = {en},
number = {12},
urldate = {2021-10-18},
journal = {Clinical Gastroenterology and Hepatology},
author = {Krigel, Anna and Chen, Ling and Wright, Jason D. and Lebwohl, Benjamin},
month = nov,
year = {2019},
note = {ZSCC: 0000019},
keywords = {Cost, Endoscopy, Propofol, Sedation, Unread},
pages = {2489--2496},
}
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{"_id":"QNTJYeXcRLHFKo8wr","bibbaseid":"krigel-chen-wright-lebwohl-substantialincreaseinanesthesiaassistanceforoutpatientcolonoscopyandassociatedcostnationwide-2019","author_short":["Krigel, A.","Chen, L.","Wright, J. D.","Lebwohl, B."],"bibdata":{"bibtype":"article","type":"article","title":"Substantial Increase in Anesthesia Assistance for Outpatient Colonoscopy and Associated Cost Nationwide","volume":"17","issn":"1542-3565","url":"https://www.sciencedirect.com/science/article/pii/S1542356519300102","doi":"10/gm5nzj","abstract":"Background and Aims The use of anesthesia assistance (AA) for outpatient colonoscopy has been increasing over the past decade, raising concern over its effects on procedure safety, quality, and cost. We performed a nationwide claims-based study to determine regional, patient-related, and facility-related patterns of anesthesia use as well as cost implications of AA for payers. Methods We analyzed the Premier Perspective database to identify patients undergoing outpatient colonoscopy at over 600 acute-care hospitals throughout the United States from 2006 through 2015, with or without AA. We used multivariable analysis to identify factors associated with AA and cost. Results We identified 4,623,218 patients who underwent outpatient colonoscopy. Of these, 1,671,755 (36.2%) had AA; the proportion increased from 16.7% in 2006 to 58.1% in 2015 (P \\textless .001). Factors associated with AA included younger age (odds ratios [ORs], compared to patients 18-39 years old: 0.94, 0.82, 0.77, 0.72, and 0.77 for age groups 40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years, respectively); and female sex (OR, 0.96 for male patients compared to female patients; 95% CI, 0.95-0.96). Black patients were less likely to receive AA than white patients (OR, 0.81; 95% CI, 0.81-0.82), although this difference decreased with time. The median cost of outpatient colonoscopy with AA was higher among all payers, ranging from $182.43 (95% CI, $180.80-$184.06) higher for patients with commercial insurance to $232.62 (95% CI, $222.58-$242.67) higher for uninsured patients. Conclusions In an analysis of a database of patients undergoing outpatient colonoscopy throughout the United States, we found that the use of AA during outpatient colonoscopy increased significantly from 2006 through 2015, associated with increased cost for all payers. The increase in anesthesia use mandates evaluation of its safety and effectiveness in colorectal cancer screening programs.","language":"en","number":"12","urldate":"2021-10-18","journal":"Clinical Gastroenterology and Hepatology","author":[{"propositions":[],"lastnames":["Krigel"],"firstnames":["Anna"],"suffixes":[]},{"propositions":[],"lastnames":["Chen"],"firstnames":["Ling"],"suffixes":[]},{"propositions":[],"lastnames":["Wright"],"firstnames":["Jason","D."],"suffixes":[]},{"propositions":[],"lastnames":["Lebwohl"],"firstnames":["Benjamin"],"suffixes":[]}],"month":"November","year":"2019","note":"ZSCC: 0000019","keywords":"Cost, Endoscopy, Propofol, Sedation, Unread","pages":"2489–2496","bibtex":"@article{krigel_substantial_2019,\n\ttitle = {Substantial {Increase} in {Anesthesia} {Assistance} for {Outpatient} {Colonoscopy} and {Associated} {Cost} {Nationwide}},\n\tvolume = {17},\n\tissn = {1542-3565},\n\turl = {https://www.sciencedirect.com/science/article/pii/S1542356519300102},\n\tdoi = {10/gm5nzj},\n\tabstract = {Background and Aims\nThe use of anesthesia assistance (AA) for outpatient colonoscopy has been increasing over the past decade, raising concern over its effects on procedure safety, quality, and cost. We performed a nationwide claims-based study to determine regional, patient-related, and facility-related patterns of anesthesia use as well as cost implications of AA for payers.\nMethods\nWe analyzed the Premier Perspective database to identify patients undergoing outpatient colonoscopy at over 600 acute-care hospitals throughout the United States from 2006 through 2015, with or without AA. We used multivariable analysis to identify factors associated with AA and cost.\nResults\nWe identified 4,623,218 patients who underwent outpatient colonoscopy. Of these, 1,671,755 (36.2\\%) had AA; the proportion increased from 16.7\\% in 2006 to 58.1\\% in 2015 (P {\\textless} .001). Factors associated with AA included younger age (odds ratios [ORs], compared to patients 18-39 years old: 0.94, 0.82, 0.77, 0.72, and 0.77 for age groups 40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years, respectively); and female sex (OR, 0.96 for male patients compared to female patients; 95\\% CI, 0.95-0.96). Black patients were less likely to receive AA than white patients (OR, 0.81; 95\\% CI, 0.81-0.82), although this difference decreased with time. The median cost of outpatient colonoscopy with AA was higher among all payers, ranging from \\$182.43 (95\\% CI, \\$180.80-\\$184.06) higher for patients with commercial insurance to \\$232.62 (95\\% CI, \\$222.58-\\$242.67) higher for uninsured patients.\nConclusions\nIn an analysis of a database of patients undergoing outpatient colonoscopy throughout the United States, we found that the use of AA during outpatient colonoscopy increased significantly from 2006 through 2015, associated with increased cost for all payers. The increase in anesthesia use mandates evaluation of its safety and effectiveness in colorectal cancer screening programs.},\n\tlanguage = {en},\n\tnumber = {12},\n\turldate = {2021-10-18},\n\tjournal = {Clinical Gastroenterology and Hepatology},\n\tauthor = {Krigel, Anna and Chen, Ling and Wright, Jason D. and Lebwohl, Benjamin},\n\tmonth = nov,\n\tyear = {2019},\n\tnote = {ZSCC: 0000019},\n\tkeywords = {Cost, Endoscopy, Propofol, Sedation, Unread},\n\tpages = {2489--2496},\n}\n\n\n\n\n\n\n\n\n\n\n\n","author_short":["Krigel, A.","Chen, L.","Wright, J. D.","Lebwohl, B."],"key":"krigel_substantial_2019","id":"krigel_substantial_2019","bibbaseid":"krigel-chen-wright-lebwohl-substantialincreaseinanesthesiaassistanceforoutpatientcolonoscopyandassociatedcostnationwide-2019","role":"author","urls":{"Paper":"https://www.sciencedirect.com/science/article/pii/S1542356519300102"},"keyword":["Cost","Endoscopy","Propofol","Sedation","Unread"],"metadata":{"authorlinks":{}},"html":""},"bibtype":"article","biburl":"https://bibbase.org/zotero/nikitaj.greenidge","dataSources":["uXDRqZDxuAtbLLS2T"],"keywords":["cost","endoscopy","propofol","sedation","unread"],"search_terms":["substantial","increase","anesthesia","assistance","outpatient","colonoscopy","associated","cost","nationwide","krigel","chen","wright","lebwohl"],"title":"Substantial Increase in Anesthesia Assistance for Outpatient Colonoscopy and Associated Cost Nationwide","year":2019}