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'Opt Out' Doesn't Increase Access to Anesthesia Care

No increase in number of patients traveling outside home zip code, except for total hip arthroplasty

anesthesia mask

WEDNESDAY, Jan. 25, 2017 (HealthDay News) -- The "opt out" rule, which allows U.S. states to opt out of the regulations requiring physician supervision of nurse anesthetists has not increased access to anesthesia care for certain common procedures, according to a study published online Jan. 19 in Anesthesiology.

Eric C. Sun, M.D., Ph.D., from Stanford University in California, and colleagues used Medicare administrative claims data to assess whether "opt out" reduces the distance traveled by patients, a measure of access, among those undergoing total knee arthroplasty, total hip arthroplasty, cataract surgery, colonoscopy/sigmoidoscopy, esophagogastroduodenoscopy, appendectomy, or hip fracture repair. For cataract surgery, colonoscopy/sigmoidoscopy, or esophagogastroduodenoscopy, they also examined whether "opt out" correlated with increased use of anesthesia care.

The researchers observed no reduction in the percentage of patients who traveled outside their home zip code with "opt out," except for total hip arthroplasty (2.2 percent reduction; P = 0.007). "Opt out" had no significant effect on the distance traveled for any of the procedures examined among patients traveling outside their zip code, with point estimates varying from a 7.9-km decrease to a 1.6-km increase for appendectomy and total hip arthroplasty, respectively. "Opt out" had no significant effect on anesthesia use for esophagogastroduodenoscopy, appendectomy, or cataract surgery.

"'Opt out' was associated with little or no increased access to anesthesia care for several common procedures," the authors write.

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