Scope of Practice Laws and Anesthesia Complications
No Measurable Impact of Certified Registered Nurse Anesthetist Expanded Scope of Practice on Anesthesia-related Complications
Bibliographic Data
| ID | 9101496 |
|---|---|
| Authors | Brighita Negrusa (Lewin Group (United States)), Paul F Hogan (Lewin Group (United States)), John T Warner (Lewin Group (United States)), Caryl H Schroeder (Lewin Group (United States)), Bo Pang (0000-0002-6411-8628, Lewin Group (United States)) |
| Year | 2016 |
| Volume | 54 |
| Issue | 10 |
| Pages | 913-920 |
| Publication date | 2016-10-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000554 |
| PMID | 27213547 |
| OpenAlex | W2400520961 |
| Language | EN |
| Citations received | 5 |
| References cited | 7 |
BACKGROUND: Scope of practice (SOP) laws governing Certified Registered Nurse Anesthetists (CRNAs) vary by state and drive CRNA practice and reimbursement. OBJECTIVE: To test whether the odds of an anesthesia complication vary by SOP and delivery model (CRNA only, anesthesiologist only, or mixed anesthesiologist and CRNAs team). METHODS: Anesthesia claims and related complications were identified in a large commercial payor database, including inpatient and ambulatory settings. Logit regression models were estimated by setting to determine the impact of SOP and delivery model on the odds of an anesthesia-related complication, while controlling for patient characteristics, patient comorbidities, procedure and procedure complexity, and local area economic factors. RESULTS: Overall, 8 in every 10,000 anesthesia-related procedures had a complication. However, complications were 4 times more likely in the inpatient setting (20 per 10,000) than the outpatient setting (4 per 10,000). In both settings, the odds of a complication were found to differ significantly with patient characteristics, patient comorbidities, and the procedures being administered. The odds of an anesthesia-elated complication are particularly high for procedures related to childbirth. However, complication odds were not found to differ by SOP or delivery model. CONCLUSIONS: Our research results suggest that there is strong evidence of differences in the likelihood of anesthesia complications by patient characteristics, patient comorbidities, and the procedures being administered, but virtually no evidence that the odds of a complication differ by SOP or delivery model
Ambulatory · Anesthesia · Complication · Health care · Intensive care medicine · Logistic regression · Nurse anesthetist · Odds · Odds ratio · Reimbursement · Cardiac, Anesthesia and Surgical Outcomes · Emergency Medicine · Healthcare Operations and Scheduling Optimization · Internal Medicine · Medicine · Nursing Roles and Practices · Surgery
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| Unique citing works | 5 |
|---|---|
| Citations per year | 0,71 |
| Citation span | 2019 - 2025 (7) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 5 |