[Cost analysis and potential savings related to the use of preoperative tests in the hospitals of the Canary Islands [Spain]].
OBJECTIVE
To estimate the potential cost savings that might take place in the Canary Islands Health Service (CHS) through the appropriate scientific use of preoperative tests, using information obtained from five public university hospitals.


METHODS
A questionnaire was completed by 55 anesthesiologists, representing 60% of the total in the CHS. The questionnaire paid special attention to the most frequently used preoperative tests: chest radiograph, electrocardiogram, laboratory tests, and spirometry. The mean unit costs for the various preoperative tests were obtained from the two hospitals participating in the study. To calculate the potential cost savings derived from the appropriate use of preoperative tests, several scenarios were considered. These were characterized by different hypotheses or degrees of fulfillment of a protocol based on scientific knowledge and considered as the gold standard.


RESULTS
In the ideal scenario in which the recommended scientific protocol was fulfilled in 100% of the 16 179 patients with an American Society of Anesthesiologists (ASA) grade of I-II, the economic impact would be notable, since it would free sensitive resources that could be used for other health programs. These figures could amount to approximately 1.02 million euros, without considering the cost of preoperative hospital stay. This figure could increase by up to approximately 2.13 million euros if one day of preoperative hospital stay were included and by up to 3.24 million euros if two days of preoperative hospital stay were included.


CONCLUSIONS
The recent literature review and the results of the questionnaire applied in the CHS indicate that preoperative tests are of greatest benefit to patients and to society if their use is guided by scientific knowledge. In addition, resources can be freed by better selection and utilization of preoperative tests.
Dirección del Servicio Canario de Salud. Servicio Canario de Salud. Santa Cruz de Tenerife. España. jlopbas@gobiernodecanarias.org
J
J
López-Bastida
P
P
Serrano-Aguilar
B
B
Duque-González
A
A
Talavera-Déniz
D000761:Anesthesia Department, Hospital / Q000191:economics; D001266:Atlantic Islands; D003365:Costs and Cost Analysis; D003955:Diagnostic Tests, Routine / Q000191:economics; D017721:Hospital Costs; D006779:Hospitals, Public / Q000191:economics*; D006785:Hospitals, University / Q000191:economics*; D006801:Humans; D007182:Income; D007902:Length of Stay / Q000191:economics; D011300:Preoperative Care / Q000191:economics*; D013030:Spain; D011795:Surveys and Questionnaires