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[PMID]:28486899
[Au] Autor:Keon-Cohen Z; Myles PS; Story DA
[Ad] Endereço:Consultant Anaesthetist, Box Hospital, Eastern Health, Victoria.
[Ti] Título:A survey of Australian and New Zealand anaesthetists' attitudes towards resuscitation orders in the perioperative setting.
[So] Source:Anaesth Intensive Care;45(3):396-402, 2017 05.
[Is] ISSN:0310-057X
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Not for resuscitation (NFR) orders are often suspended during anaesthesia, as perioperative care is believed to inherently involve the need for resuscitation including ventilation support. Recent legislative changes in Australia, New Zealand and the UK have enacted the binding nature of advance care directives (ACDs) in healthcare. National guidelines regarding codes of practice and government strategic plans for implementing advance care planning have reinforced the role for advance care planning in modern healthcare. We surveyed a random selection of Australian and New Zealand consultant and trainee anaesthetists to assess their attitudes towards NFR orders and ACDs in the perioperative setting. We received 290 of 790 distributed surveys (37% response rate). The majority (75%) of respondents reported their knowledge as very low, low, or moderate; 37% never or rarely were treating a patient who had an ACD. Over 90% reported that patient's wishes and understanding of ACDs is important and 89% agreed or strongly agreed that advance care planning should be a routine part of hospital admission for high risk patients. Despite this, only 45% of the respondents would always follow an ACD. Although the majority of respondents to this survey support their use in the perioperative setting, clarification of the specific applicability of ACDs to anaesthesia and their binding nature is required.
[Mh] Termos MeSH primário: Anestesistas
Atitude do Pessoal de Saúde
Ordens quanto à Conduta (Ética Médica)
[Mh] Termos MeSH secundário: Planejamento Antecipado de Cuidados
Diretivas Antecipadas
Austrália
Seres Humanos
Nova Zelândia
Assistência Perioperatória
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170511
[St] Status:MEDLINE


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[PMID]:28390846
[Au] Autor:Cohen P; Slim K; Soulier L; Theissen A
[Ad] Endereço:Cabinet d'avocats Aubert, 7, rue Aubert, 75009 Paris, France.
[Ti] Título:[Surgeons-anesthetists relations: From an individual responsibility of the surgeon to a shared responsibility with the anesthetist].
[Ti] Título:Relations chirurgiens/anesthésistes-réanimateurs : d'une responsabilité individuelle du chirurgien à une responsabilité partagée avec l'anesthésiste-réanimateur..
[So] Source:Presse Med;46(5):472-477, 2017 May.
[Is] ISSN:2213-0276
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Throughout the perioperative period, anesthetists and surgeons jointly provide care for patients. The advances in medicine and surgery, the practice of perioperative quality medicine and the recent application of enhanced recovery program after surgery have necessitated strengthening the place of each in its area of expertise while developing the spirit team and communication. Thus, alongside the surgeon who was once considered the head of the surgical team, the anesthetist's role has been to consolidate for the management of the surgical patient and had his spot empower themselves in the eye of the patient with the birth an own contract with the patient (due in particular to the obligation to preanesthetic consultation by the decree of December 5, 1994). This has led to a new division of responsibility between these actors: jurisprudence has abandoned the exclusive responsibility of the surgeon, devoted own responsibility of the anesthetist with a division (if any) of responsibility between the anesthetist and the surgeon.
[Mh] Termos MeSH primário: Anestesistas
Relações Interprofissionais
Papel do Médico
Cirurgiões
[Mh] Termos MeSH secundário: Anestesistas/legislação & jurisprudência
França
Seres Humanos
Equipe de Assistência ao Paciente/legislação & jurisprudência
Cirurgiões/legislação & jurisprudência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170410
[St] Status:MEDLINE


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[PMID]:28376246
[Au] Autor:Doumouras AG; Hamidi M; Lung K; Tarola CL; Tsao MW; Scott JW; Smink DS; Yule S
[Ad] Endereço:School of Public Health, Harvard University, Boston, Massachusetts, USA.
[Ti] Título:Non-technical skills of surgeons and anaesthetists in simulated operating theatre crises.
[So] Source:Br J Surg;104(8):1028-1036, 2017 Jul.
[Is] ISSN:1365-2168
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Deficiencies in non-technical skills (NTS) have been increasingly implicated in avoidable operating theatre errors. Accordingly, this study sought to characterize the impact of surgeon and anaesthetist non-technical skills on time to crisis resolution in a simulated operating theatre. METHODS: Non-technical skills were assessed during 26 simulated crises (haemorrhage and airway emergency) performed by surgical teams. Teams consisted of surgeons, anaesthetists and nurses. Behaviour was assessed by four trained raters using the Non-Technical Skills for Surgeons (NOTSS) and Anaesthetists' Non-Technical Skills (ANTS) rating scales before and during the crisis phase of each scenario. The primary endpoint was time to crisis resolution; secondary endpoints included NTS scores before and during the crisis. A cross-classified linear mixed-effects model was used for the final analysis. RESULTS: Thirteen different surgical teams were assessed. Higher NTS ratings resulted in significantly faster crisis resolution. For anaesthetists, every 1-point increase in ANTS score was associated with a decrease of 53·50 (95 per cent c.i. 31·13 to 75·87) s in time to crisis resolution (P < 0·001). Similarly, for surgeons, every 1-point increase in NOTSS score was associated with a decrease of 64·81 (26·01 to 103·60) s in time to crisis resolution in the haemorrhage scenario (P = 0·001); however, this did not apply to the difficult airway scenario. Non-technical skills scores were lower during the crisis phase of the scenarios than those measured before the crisis for both surgeons and anaesthetists. CONCLUSION: A higher level of NTS of surgeons and anaesthetists led to quicker crisis resolution in a simulated operating theatre environment.
[Mh] Termos MeSH primário: Anestesistas/normas
Competência Clínica/normas
Cirurgiões/normas
[Mh] Termos MeSH secundário: Obstrução das Vias Respiratórias/prevenção & controle
Anestesistas/educação
Conscientização
Perda Sanguínea Cirúrgica/prevenção & controle
Tomada de Decisão Clínica
Comunicação
Seres Humanos
Capacitação em Serviço/métodos
Relações Interprofissionais
Liderança
Treinamento por Simulação/métodos
Cirurgiões/educação
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170405
[St] Status:MEDLINE
[do] DOI:10.1002/bjs.10526


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[PMID]:28288946
[Au] Autor:Mion G; Boiguile K; Bidou A; Limare M
[Ad] Endereço:Département d'Anesthésie Réanimation, Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, 75679 Paris cedex 14, France. Electronic address: georges-mion@bbox.fr.
[Ti] Título:Burnout among French anaesthetists and intensivists: Adequate progress is still lacking.
[So] Source:Anaesth Crit Care Pain Med;36(4):247-248, 2017 08.
[Is] ISSN:2352-5568
[Cp] País de publicação:France
[La] Idioma:eng
[Mh] Termos MeSH primário: Anestesistas
Esgotamento Profissional
[Mh] Termos MeSH secundário: Anestesiologia
Cuidados Críticos
França
Seres Humanos
Unidades de Terapia Intensiva
Satisfação no Emprego
Médicos
Estresse Psicológico
Inquéritos e Questionários
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170315
[St] Status:MEDLINE


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[PMID]:28267936
[Au] Autor:Kolawole H; Marshall SD; Crilly H; Kerridge R; Roessler P
[Ad] Endereço:Specialist Anaesthetist, Anaesthesia, Peninsula Health, Adjunct Senior Lecturer, Anaesthesia and Perioperative Medicine, Monash University, Melbourne, Victoria.
[Ti] Título:Australian and New Zealand Anaesthetic Allergy Group/Australian and New Zealand College of Anaesthetists Perioperative Anaphylaxis Management Guidelines.
[So] Source:Anaesth Intensive Care;45(2):151-158, 2017 03.
[Is] ISSN:0310-057X
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Anaphylaxis is an uncommon but important cause of serious morbidity and even mortality in the perioperative period. The Australian and New Zealand College of Anaesthetists (ANZCA) with the Australian and New Zealand Anaesthetic Allergy Group (ANZAAG) have developed clinical management guidelines that include six crisis management cards. The content of the guidelines and cards is based on published literature and other international guidelines for the management of anaesthesia-related and non-anaesthesia-related anaphylaxis. The evidence is summarised in the associated background paper (Perioperative Anaphylaxis Management Guidelines [2016] www.anzca.edu.au/resources/endorsed-guidelines and www.anzaag.com/Mgmt%20Resources.aspx). These guidelines are intended to apply to anaphylaxis occurring only during the perioperative period. They are not intended to apply to anaphylaxis outside the setting of dedicated monitoring and management by an anaesthetist. In this paper guidelines will be presented along with a brief background to their development.
[Mh] Termos MeSH primário: Anafilaxia/terapia
Guias de Prática Clínica como Assunto
[Mh] Termos MeSH secundário: Anestesistas
Austrália
Seres Humanos
Nova Zelândia
Período Perioperatório
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170619
[Lr] Data última revisão:
170619
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170308
[St] Status:MEDLINE


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[PMID]:28230439
[Au] Autor:Hersey P; McAleer S
[Ad] Endereço:Consultant in Intensive Care Medicine and Anaesthesia, City Hospitals Sunderland NHS Foundation Trust.
[Ti] Título:Developing an e-learning resource for nurse airway assistants in the emergency department.
[So] Source:Br J Nurs;26(4):217-221, 2017 Feb 23.
[Is] ISSN:0966-0461
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The aims of this project were to determine the required competencies for a nurse in the emergency department assisting with a rapid sequence induction of anaesthesia (RSI), and to produce a relevant e-learning resource. A three-round multidisciplinary Delphi process produced the following competencies: ability to describe the steps and sequence of events of an RSI, familiarity with the equipment used during an RSI, ability to recognise and help manage problems occurring during an RSI, ability to prepare for an RSI, ability to apply cricoid pressure, and understanding the modification of an RSI in special circumstances. An interactive e-learning package was produced and made available online. Twelve emergency department nurses took part in an evaluation of the e-learning package. All either agreed or strongly agreed that they had increased their knowledge and found the learning useful, and 11 out of 12 nurses reported being somewhat or very confident in the role of airway assistant following completion of the learning.
[Mh] Termos MeSH primário: Manuseio das Vias Aéreas/enfermagem
Anestesia/enfermagem
Anestesistas/educação
Competência Clínica
Instrução por Computador/métodos
Enfermagem em Emergência/educação
Internet
[Mh] Termos MeSH secundário: Técnica Delfos
Educação Continuada em Enfermagem/métodos
Serviço Hospitalar de Emergência
Seres Humanos
Aprendizagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170620
[Lr] Data última revisão:
170620
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170224
[St] Status:MEDLINE
[do] DOI:10.12968/bjon.2017.26.4.217


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[PMID]:28091758
[Au] Autor:Maier C; Iwunna J; Tsokos M; Mußhoff F
[Ad] Endereço:Abteilung für Schmerzmedizin, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland. christoph.maier@rub.de.
[Ti] Título:[Deaths from propofol abuse : Survey of institutes of forensic medicine in Germany, Austria and Switzerland].
[Ti] Título:Todesfälle durch Propofolmissbrauch : Befragung in rechtsmedizinischen Instituten in Deutschland, Österreich und der Schweiz..
[So] Source:Anaesthesist;66(2):109-114, 2017 Feb.
[Is] ISSN:1432-055X
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Previous references suggesting a high mortality of propofol addiction in medical personnel were mostly based on surveys of the heads of medical departments or case reports; therefore, a questionnaire was sent to 48 forensic medicine departments in Germany, Austria and Switzerland concerning the number of autopsies carried out between 2002-2112 on medical personnel with the suspicion of abuse of propofol or other analgesics. The response rate was 67%. In 16 out of the 32 responding departments 39 deaths (27 males) were observed with previous connections to anesthesiology, intensive care or emergency departments of which 22 were physicians, 13 nurses, 2 other personnel and 2 were unknown. Propofol was the major cause of death in 33 cases (85%), in 8 cases including 7 with propofol, an unintentional accident was recorded and 29 were determined to be suicide. In 14 cases chronic abuse was denied but actually excluded by toxicological analysis in only 2 cases. In 11 cases involving suicide the question of abuse was not investigated. This survey confirmed previous data about the central role of propofol for the fatal outcome of addiction and suicide of anesthetists and other medical personnel. A dual prevention strategy with low-threshold offers for persons at risk and strategies for early detection is urgently needed including a stricter control of dispensing, improvement in forensic medical documentation and the use of toxicological investigations in every case of suspected abuse.
[Mh] Termos MeSH primário: Anestésicos Intravenosos
Propofol
Transtornos Relacionados ao Uso de Substâncias/mortalidade
[Mh] Termos MeSH secundário: Adulto
Anestesistas
Áustria/epidemiologia
Causas de Morte
Documentação
Feminino
Alemanha/epidemiologia
Pessoal de Saúde
Seres Humanos
Masculino
Meia-Idade
Enfermeiras e Enfermeiros
Inabilitação do Médico
Médicos
Suicídio/estatística & dados numéricos
Suíça/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Intravenous); YI7VU623SF (Propofol)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170916
[Lr] Data última revisão:
170916
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170117
[St] Status:MEDLINE
[do] DOI:10.1007/s00101-016-0260-6


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[PMID]:27930962
[Au] Autor:Flynn FM; Sandaker K; Ballangrud R
[Ad] Endereço:Department of Nursing Science, Faculty of Health Sciences, University College of Southeast, Norway. Electronic address: fiona.flynn@hbv.no.
[Ti] Título:Aiming for excellence - A simulation-based study on adapting and testing an instrument for developing non-technical skills in Norwegian student nurse anaesthetists.
[So] Source:Nurse Educ Pract;22:37-46, 2017 Jan.
[Is] ISSN:1873-5223
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:There is increasing focus on building safety into anaesthesia practice, with excellence in anaesthesia as an aspirational goal. Non-technical skills are an important factor in excellence and improved patient safety, though there have been few systematic attempts at integrating them into anaesthesia nursing education. This study aimed to test the reliability of NANTS-no, a specially adapted behavioural marker system for nurse anaesthetists in Norway, and explore the development of non-technical skills in student nurse anaesthetists. The pre-test post-test design incorporated a 10-week simulation-based programme, where non-technical skills in 14 student nurse anaesthetists were rated on three different occasions during high-fidelity simulation, before and after taking part in a training course. NANTS-no demonstrated high overall inter-rater reliability (ICC = 0.91), high test-retest reliability (ICC = 0.94) and good internal consistency (Cronbach's α of 0.85-0.92). A significant improvement was demonstrated across all categories of non-technical skills, with greatest improvements between the first and third and second and third sessions. There was also a significant improvement in two categories between the first and second sessions. NANTS-no is therefore suitable for assessing non-technical skills during simulation training in anaesthesia nursing education. More research is needed to validate its use in clinical practice.
[Mh] Termos MeSH primário: Anestesistas
Competência Clínica
Treinamento com Simulação de Alta Fidelidade/métodos
Estudantes de Enfermagem
[Mh] Termos MeSH secundário: Adulto
Anestesiologia/educação
Seres Humanos
Noruega
Reprodutibilidade dos Testes
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170227
[Lr] Data última revisão:
170227
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:161209
[St] Status:MEDLINE


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[PMID]:27402501
[Au] Autor:Buxbaum J; Roth N; Motamedi N; Lee T; Leonor P; Salem M; Gibbs D; Vargo J
[Ad] Endereço:Division of Gastroenterology and Liver Diseases, The University of Southern California, Keck School of Medicine, Los Angeles, California, USA.
[Ti] Título:Anesthetist-Directed Sedation Favors Success of Advanced Endoscopic Procedures.
[So] Source:Am J Gastroenterol;112(2):290-296, 2017 Feb.
[Is] ISSN:1572-0241
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Sedation is required to perform endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) given the duration and complexity of these advanced procedures. Sedation options include anesthetist-directed sedation (ADS) vs. gastroenterologist-directed sedation (GDS). Although ADS has been shown to shorten induction and recovery times, it is not established whether it impacts likelihood of procedure completion. Our aim was to assess whether ADS impacts the success of advanced endoscopy procedures. METHODS: We prospectively assessed the sedation strategy for patients undergoing ERCP and EUS between October 2010 and October 2013. Although assignment to ADS vs. GDS was not randomized, it was determined by day of the week. A sensitivity analysis using propensity score matching was used to model a randomized trial. The main outcome, procedure failure, was defined as an inability to satisfactorily complete the ERCP or EUS such that an additional endoscopic, radiographic, or surgical procedure was required. Failure was further categorized as failure due to inadequate sedation vs. technical problems. RESULTS: During the 3-year study period, 60% of the 1,171 procedures were carried out with GDS and 40% were carried out with ADS. Failed procedures occurred in 13.0% of GDS cases compared with 8.9% of ADS procedures (multivariate odds ratio (OR): 2.4 (95% confidence interval (CI): 1.5-3.6)).This was driven by a higher rate of sedation failures in the GDS group, 7.0%, than in the ADS group, 1.3% (multivariate OR: 7.8 (95% CI: 3.3-18.8)). There was no difference in technical success between the GDS and ADS groups (multivariate OR: 1.2 (95% CI: 0.7-1.9)). We were able to match 417 GDS cases to 417 ADS cases based on procedure type, indication, and propensity score. Analysis of the propensity score-matched patients confirmed our findings of increased sedation failure (multivariate OR: 8.9 (95% CI: 2.5-32.1)) but not technical failure (multivariate OR: 1.2 (0.7-2.2)) in GDS compared with ADS procedures. Adverse events of sedation were rare in both groups. Failed ERCP in the GDS group resulted in a total of 93 additional days of hospitalization. We estimate that $67,891 would have been saved if ADS had been used for all ERCP procedures. No statistically significant difference in EUS success was identified, although this sub-analysis was limited by sample size. CONCLUSION: ADS improves the success of advanced endoscopic procedures. Its routine use may increase the quality and efficiency of these services.
[Mh] Termos MeSH primário: Colangiopancreatografia Retrógrada Endoscópica/métodos
Sedação Consciente/métodos
Sedação Profunda/métodos
Endossonografia/métodos
Gastroenterologistas
Custos de Cuidados de Saúde
Enfermeiras Anestesistas
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Anestesia Geral/economia
Anestesia Geral/métodos
Anestesistas
Criança
Colangiopancreatografia Retrógrada Endoscópica/economia
Sedação Consciente/economia
Sedação Profunda/economia
Endossonografia/economia
Feminino
Seres Humanos
Masculino
Meia-Idade
Análise Multivariada
Razão de Chances
Duração da Cirurgia
Pontuação de Propensão
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171101
[Lr] Data última revisão:
171101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160713
[St] Status:MEDLINE
[do] DOI:10.1038/ajg.2016.285


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[PMID]:27349340
[Au] Autor:Predmore Z; Nie X; Main R; Mattke S; Liu H
[Ad] Endereço:RAND Corporation, Boston, Massachusetts, USA.
[Ti] Título:Anesthesia Service Use During Outpatient Gastroenterology Procedures Continued to Increase From 2010 to 2013 and Potentially Discretionary Spending Remained High.
[So] Source:Am J Gastroenterol;112(2):297-302, 2017 Feb.
[Is] ISSN:1572-0241
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: 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. The aim of this study was to update these trends with the most recent years of data. METHODS: We 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. We 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. RESULTS: Over 6.6 million patients in our sample had a GI procedure between 2010 and 2013. GI procedures involving anesthesia service accounted for 33.7% in 2010 and 47.6% in 2013 in Medicare patients, and 38.3% in 2010 and 53.0% in 2013 in commercially insured patients. Overall, 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, we 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. CONCLUSIONS: 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.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Ambulatórios/métodos
Anestesistas/utilização
Endoscopia do Sistema Digestório/métodos
Gastroenterologia/métodos
Gastos em Saúde
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Procedimentos Cirúrgicos Ambulatórios/economia
Procedimentos Cirúrgicos Ambulatórios/tendências
Anestesistas/economia
Anestesistas/tendências
Sedação Consciente/economia
Sedação Consciente/métodos
Sedação Consciente/tendências
Sedação Profunda/economia
Sedação Profunda/métodos
Sedação Profunda/tendências
Endoscopia do Sistema Digestório/economia
Endoscopia do Sistema Digestório/tendências
Feminino
Gastroenterologia/economia
Gastroenterologia/tendências
Seres Humanos
Armazenamento e Recuperação da Informação
Modelos Logísticos
Masculino
Medicare
Meia-Idade
Análise Multivariada
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171101
[Lr] Data última revisão:
171101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160629
[St] Status:MEDLINE
[do] DOI:10.1038/ajg.2016.266



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BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde