It is no secret healthcare costs in the US are skyrocketing. In 2010, the average American spent a total of $8,223 per year on healthcare, yet the US Healthcare System lags behind most other countries in the Organization for Economic Co-operation and Development (OECD).

For all of the taxpayer’s money spent, more than any other country per capita, US citizens don’t get nearly the return on investment that our peers in comparable countries get.

How can we cut costs and provide quality health services?

Optimizing the United States’ Healthcare System is a complex issue. There isn’t an easy button, fix-all solution for all of the problems our healthcare system has but, there are many solutions that can help reduce costs and get it back in line and economically viable.

For example, it costs up to five times as much money to train an anesthesiologist than it does a certified registered nurse anesthetist (CRNA). Anesthesiologists also require more than twice as much in salary over a comparable CRNA. ($340,000 vs. $160,000)

For the last two decades, there has been a sharp rise in operative case loads in the US which has risen much faster than anticipated. The availability of anesthesiologists for these increasing case loads has decreased drastically. The need for anesthesia services not only increased in densely populated areas, but they increased in the rural areas as well. This led to an increase in nurse anesthetists being trained to off-set the imbalance  and to handle the increase in workload.

However, due to the algorithmic and “checklist” nature of their specialty, anesthesiologist’s operating procedures were easily learned and utilized by CRNAs during their time working under an anesthesiologist.

According to the AANA, CRNA’s acting as the sole anesthesia provider is by far the most cost effective model of anesthesia delivery. Choosing to have a CRNA as the sole provider of anesthesia costs, on average, nearly 25% less than their anesthesiologist counterparts.

Is there a difference in quality of service with CRNA’s as opposed to an anesthesiologist based model?

According to Paul F. Hogan, there are no measurable differences in the quality of anesthesia care between CRNAs and anesthesiologists. To review the white paper report in its entirety, please see “Cost Effectiveness Analysis of Anesthesia Providers.”

In fact, quality and availability of anesthesia care may indeed be far better with CRNAs than with anesthesiologists.

Due to the cost effectiveness and availability of CRNAs, citizens living in rural and less densely populated areas have access to great anesthesia care through a CRNA based anesthesia group, whereas the higher pay and lower availability of anesthesiologists cannot be provided in those areas.

The United States has to start getting serious about cutting costs and increasing effectiveness of money spent on healthcare. There are options available to increase the value of healthcare in our country, we just have to make the right decisions and become more progressive in how we provide our services to our patients.

reference: NURSING ECONOMIC$/May-June 2010/Vol. 28/No. 3

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