title: Effect of perioperative evaluation and consultation on cost and outcome of surgical care.
abstract: The preoperative evaluation has traditionally focused on identifying the subset of patients for whom further testing would identify patients at increased risk. The past decade has seen a reorientation to focus on developing systems, both guidelines and preoperative evaluation clinics, that can reduce the number of unindicated testing and more appropriately direct the preoperative evaluation as a means of reducing costs. In patients who are at risk for cardiac disease administrative data-sets have been used to link perioperative interventions with outcome. Future research must be directed at proving effectiveness in randomized clinical trials.
authors.affiliation: Department of Anesthesiology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA. lfleishe@jhmi.edu
authors.forename: L A
authors.initials: LA
authors.lastname: Fleisher