title: International comparison of preoperative testing and assessment protocols and best practices to reduce surgical care costs: a systematic literature review.
abstract: OBJECTIVE
  Health care institutions in many Western countries have developed preoperative testing and assessment guidelines to improve surgical outcomes and reduce cost of surgical care. The aims of this chapter are to (1) summarize the literature on the effect of preoperative testing on clinical outcomes, efficiency, and cost; and (2) to compare preoperative testing guidelines developed in the United States, the United Kingdom, and Canada.
  
  
  METHODS
  We reviewed the literature from 1975 to 2014 for studies and preoperative testing guidelines.
  
  
  RESULTS
  We identified 29 empirical studies and 8 country-specific guidelines for review. Most studies indicate that preoperative testing is overused and comes at a high cost. Guidelines are tied to payment only in one country studied. This is the most recent review of the literature on preoperative testing and assessment with a focus on quality of care, efficiency, and cost outcomes. In addition, this chapter provides an international comparison of preoperative guidelines.
authors.forename: Bita A
authors.initials: BA
authors.lastname: Kash
authors.forename: Kayla M
authors.initials: KM
authors.lastname: Cline
authors.forename: Stephen
authors.initials: S
authors.lastname: Timmons
authors.forename: Rahil
authors.initials: R
authors.lastname: Roopani
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Miller
mesh_terms: D002170:Canada; D003363:Cost Control; D003955:Diagnostic Tests, Routine / Q000592:standards*; D017598:Efficiency, Organizational; D019317:Evidence-Based Medicine; D006801:Humans; D038622:Internationality; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000592:standards*; D011785:Quality Assurance, Health Care; D013514:Surgical Procedures, Operative / Q000191:economics*; D000078202:Systematic Reviews as Topic; D006113:United Kingdom; D014481:United States