Study Shows CRNA-Only Anesthesia Deli...

Study Shows CRNA-Only Anesthesia Delivery Most Cost Effective

There are 40 comments on the AANA Journal story from Jun 22, 2010, titled Study Shows CRNA-Only Anesthesia Delivery Most Cost Effective. In it, AANA Journal reports that:

A Certified Registered Nurse Anesthetist 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 .

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Freedom, PA

#1 Jun 22, 2010
Of course a nursing journal is going to say that CRNA's are "cost-effective". It would be even more cost effective to have some OR nurse who has experience just do the anesthesia, cheaper is better? I didn;t have a problem with CRNA's until I started to hear a noisy few rant: "CRNA's are just as qualified as anesthesiologists"....... .you hear this on the net and maybe in a group of CRNA's, but never in a group that includes MD's.

Phoenixville, PA

#2 Jun 23, 2010

a 1 million dollar investment with no significant differences in day to day results?

Sounds like a bad investment to me.

All studies show team approaches (whomever the provider) work better in anesthesia anyway, not MD only or CRNA only.

Phoenixville, PA

#3 Jun 23, 2010
David, your from my town!

I believe your statement, "All studies show...." is a bit inaccurate. To what studies do you refer?

United States

#4 Jun 23, 2010
To james, there has been no study that has shown any difference in outcomes, the study really is about dollars and cents and truth is CRNA anesthesia is less expensive and just as safe, not OR nurses. Really a red herring argument.

Bethania, NC

#5 Jun 24, 2010
The reason you probably don't hear these comments in an MD, CRNA group is because the CRNA's are probably afraid of loosing their jobs if they speak up.

Nashville, TN

#6 Jun 28, 2010
If you read the article the first issue the Lewin Group addressed in their independent study was the issue of safety and patient outcomes from every style of anesthesia group. They reference all the studies and closed claims they reviewed at the end of the article. Every credible study and all of the closed claims cases they reviewed showed no difference in patient outcomes regardless of the type of anesthesia provider or group. So with that question answered with actual facts and not just opinion, the only issue to then study was cost effectiveness of the different anesthesia models... And as previously stated the study showed that CRNA only groups were 25% more cost effective than the next closest type of anesthesia group... In the era of cost control in healthcare it's only a matter of time before CRNA's take over a much larger share of the anesthesia market... MD's can get as mad as they want about that but it's what will eventually happen.
Anesthesia Provider

Winchester, VA

#7 Jul 6, 2010
CRNA equals quality care and Lewin study is just another piece of evidence based research that proves that quality is also economical at the same time

Winchester, VA

#8 Jul 6, 2010
James, you think you know anythng about what you are saying. And physician journals don't lean one way or another on this topic of economics...go back to the drawing board son and reread or maybe
even read for the first time some of the literature you think you are makng reference too. Talk about speaking out of your A"$!
avoid crna

Donora, PA

#9 Aug 3, 2010
crna=anesthesiologist when 2+3 thinking person (other than a crna with an inferiorioty complex) would believe this........crna=quality care? sure, in many cases it does! crna=anesthesiologist? yep; private pilot=airline pilot, varsity baseball=majors, crack whore=professional prostitute......your "logic" is an insult to nurses everywhere. crna are economical? sure, it's "economical" to blow out the ICU patient's kidneys with the wrong drugs (then the hospital makes more on dialysis)......anesthesiologis ts aren't "mad" about the "crna situation"; most are getting disgusted that patients are getting inferior care from crna..........please keep posting; I lack the eloquence of diction to make my point; you seem to make it for me.........(too bad, I'll bet that you are a good nurse; if you want to be an anesthesiologist, you should go to med seem to have the ability and passion for it)....

United States

#10 Aug 4, 2010
What can anyone say? Your rambling post says it all, I am assuming you are trying to structure a logical paragraph, well good luck, if this is the argument we have to face my practice rights are quite secure.

Donora, PA

#11 Aug 11, 2010
stanley: stick to nursing; you have your hands full as a nurse. stay out of the OR before you and your ilk kill someone............

Brooklyn, IN

#12 Aug 11, 2010
Damn, did about 20 cases in the last 4 days and acouple thousend over the last three years, and they are still alive. Really you do not a single thing you are talking about.
Los Angeles physician

Anaheim, CA

#13 Aug 25, 2010
The new health care mantra unfortunately is saying that "cheaper" is better. As we all know, you eventually get what you pay for; and health care is NO different. An author of a study can always manipulate the data to "prove" their point. It seems as if nurses are trying to convince the public that they are "equivalent" because of studies that Nurses have done.

I guess these nurses (CRNA) would advocate abandoning primary care physicians for primary care providers (ie other nurses). Who needs an OB physician when a mid-wife is just as capable. Who would foolishly want a pediatrician or physician cardiologist take care of them when advanced practice nurses are "just as capable."

If given the choice, most Americans would choose to have physicians take care of them. Unfortunately, nurses are using the "cost effectiveness" to try to convince the public that they are cheaper.

Interesting side note, it is very peculiar how many advanced nurses have opted for more lucrative nursing specialties. Funny how they claim it wasn't for the money. Really you are not fooling anyone. I guess you can say it over and over and hope that people will eventually believe you. Most American fortunately are smarter than that.
Los Angeles physician

Anaheim, CA

#14 Aug 25, 2010
Given that anesthesia has a very low complication rate, you better not have any complications. Please spare us your self-congratulatory praises. Really no one cares how good a supposed CRNA you claim to be.
stanley wrote:
Damn, did about 20 cases in the last 4 days and acouple thousend over the last three years, and they are still alive. Really you do not a single thing you are talking about.

Bloomington, IN

#15 Aug 25, 2010
Well I guess it is all because anyone can perform an anesthetic so the supposed quality of MD anesthesia is......?
Welcome back I wondered when a ranting inane, incoherent person would post again.

Srsly, so if I have no complications it is because anesthesia as a whole has a low complication rate and if an MD has a low complication rate "no lower then mine" it is because they are an MD? LOL what a maroon.
Just sayin

Destrehan, LA

#16 Sep 5, 2010
What about AA's? A 4 year cleveland clinic study in which 46K cases were done(23K CRNA/23K AAs) showed no difference in outcome between the two groups. 15 states have opted out(Colorado on the brink), while 18 states plus the US armed forces have allowed licensing of AAs. I think there will be more than two groups slicing the proverbial pie when all is said and done. What's interesting is the same arguments used by crna's against MDs(cost effectiveness,no difference in outcomes despite the difference in education) are the arguments used by aa's against crna's. Don't worry. There will be a computer that takes all of our jobs in the next 10-20 yrs anyway.

Louisville, KY

#17 Sep 6, 2010
With AA's only able to work in the ACT model they cannot be compared to CRNA's. In many ACT practices the CRNA is limited as the AA not the AA elevated to the level of a CRNA so the two are not comparable, now when AA's can practice out of the care team then we will be able to compare.
Anti Stanley

Parlin, NJ

#18 Sep 8, 2010
I guess Stanley from Louisville, KY or from Columbus, IN believes that his experience and care is superb to most MDs. You are correct one can train a monkey to do anesthesia - surely that will be most cost effective - we will pay it in bananas. However, it not the safest route. I understand that CRNAs can do hearts and cranies, but I have observed CRNAs at work and their narrow minded approach to anesthesia. There are many great CRNAs, but even the best can learn a thing or two from MD. Stick to anesthesia and eat a humble pie - at the end of the day it is about the patient care and not about your inferiority complex.
Anesthesia Provider

Winchester, VA

#20 Sep 28, 2010
LA physician...your attitude towards CRNA practice is pretty you feel that your job is threatened by nurse anesthetist ... I feel like there is plenty of anesthesia work for all and that th public deserves safe anesthesia care, but also affordable health care...400k + is an inflated salary when compared o a competent CRNA doing the same job...

Pittsburgh, PA

#21 Nov 11, 2010
Really nasty exchanges. It looks like only one group can survive. It is amazing that any practice can have a mixture of anesthesiologists and CRNAs. Very sad. Will people continue to pay CRNA's $189,000 if it becomes an all nurse field? The salaries are inflated because of the MD's association. If MD continue to be forced out of the field of anesthesia, the salaries will plumet for CRNAs.

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