Study Shows CRNA-Only Anesthesia Delivery Is Most Cost Effective

A Certified Registered Nurse Anesthetist (CRNA) acting as the sole anesthesia provider is the most cost effective model of anesthesia delivery, according to a new study conducted by Virginia-based The Lewin Group and published in the May/June 2010 issue of the Journal of Nursing Economics.

The study, titled “Cost Effectiveness Analysis of Anesthesia Providers,” considered the different anesthesia delivery models in use in the United States today, including CRNAs acting solo, physician anesthesiologists acting solo, and various models in which a single anesthesiologist directs or supervises one to six CRNAs.  The results show that CRNAs acting as the sole anesthesia provider cost 25 percent less than the second lowest cost model. On the other end of the cost scale, the model in which one anesthesiologist supervises one CRNA is the least cost efficient model.

The study’s authors also completed a thorough review of the literature that compares the quality of anesthesia service by provider type or delivery model.  This review of published studies shows that there are no measurable differences in quality of care between CRNAs and anesthesiologists or by delivery model.

“The data confirm that CRNAs deliver anesthesia safely and cost-effectively,” said AANA President James Walker, CRNA, DNP. “With growing demands on the healthcare system nationwide, we must do all we can to make sure the nation’s healthcare professionals are used as effectively and efficiently as possible. CRNAs, who administer approximately 32 million anesthetics to patients in the United States each year, stand ready to do our part.”

The results of the Lewin study were particularly compelling for people living in rural and other areas of the United States where anesthesiologists often choose not to practice for economic reasons. The safe, cost-effective anesthesia care provided by nurse anesthetists has been a mainstay in these areas for more than 100 years, ensuring millions of patients access to surgical, obstetrical, trauma stabilization, and diagnostic procedures.

Method In order to define the most  cost-effective anesthesia delivery model, the study’s authors conducted simulation modeling and claims analysis using the Ingenix national claims database of integrated medical and financial data from commercial payers for 2008, which included 52,636 anesthesia deliveries, and the 2006 National Survey of Ambulatory Surgery (NSAS) which contains 52,223 visits. Findings regarding the quality of anesthesia care were based on a comprehensive review of nine published studies.

Nursing Economics advances nursing leadership in healthcare, with a focus on tomorrow, by providing information and thoughtful analyses of current and emerging best practices in healthcare management, economics, and policymaking. The journal supports nurse leaders and others who are responsible for directing nursing’s impact on healthcare cost and quality outcomes. The journal is published six times per year.

The Lewin Group is an Ingenix company. Ingenix, a wholly-owned subsidiary of UnitedHealth Group, was founded in 1996 to develop, acquire and integrate the world’s best-in-class healthcare information technology capabilities.  For more information, visit The Lewin Group operates with editorial independence and provides its clients with the very best expert and impartial healthcare and human services policy research and consulting services.

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