-- Robert Preidt
TUESDAY, Aug. 3 (HealthDay News) -- Patients have no increased
risk of death or complications from surgery when nurse anesthetists
work without physician oversight, a new study has found.
The findings challenge a requirement that nurse anesthetists be
supervised by an anesthesiologist or surgeon in order for an
operation to qualify for Medicare reimbursement, according to study
authors Jerry Cromwell and Brian Dulisse of the Research Triangle
Institute, a nonprofit organization based in North Carolina.
States can opt out of the requirement by petitioning the U.S.
Centers for Medicare and Medicaid Services (CMS).
Cromwell and Dulisse analyzed more than 481,000 hospitalizations
covered by Medicare and found that the frequency of nurse
anesthetists providing anesthesia without anesthesiologist
supervision increased between 1999 and 2005, from 17.6 percent to
21 percent in 14 opt-out states and from 7 percent to 10 percent in
The investigators also found no increased risk of patient death
or complications in the opt-out states and no significant
differences in patient outcomes in any of the three following
situations: certified registered nurse anesthetists working without
anesthesiologist supervision; anesthesiologists working alone; or
the two types of anesthesia providers working together.
The study, which was funded by the American Association of Nurse
Anesthetists, is published in the Aug. 3 issue of the journal
"This study shows that patient safety was not compromised by the opt-out policy. We recommend that CMS change the policy so that governors no longer have to petition for their states to opt out of this Medicare requirement," Cromwell said in a news release from the journal's publisher.
Increased use of nurse anesthetists could help save health care
costs because they typically earn less than anesthesiologists,
The American Society of Anesthesiologists has more about
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