title: Perioperative Medicine: The Value Proposition for Anesthesia?: A UK Perspective on Delivering Value from Anesthesiology.
abstract: Perioperative medicine describes the practice of patient centered, multidisciplinary, and integrated medical care of patients from the moment of contemplation of surgery until full recovery. The value proposition for perioperative medicine rests on defining benefits that outweigh the costs of change. This article discusses the concept of value in the context of healthcare and highlights a number of reasons for relative market failure. Five key opportunities for adding value in the perioperative journey are suggested: collaborative decision-making, lifestyle modification before surgery, standardization of in-hospital perioperative care, achieving full recovery after surgery, and the use of data for quality improvement.
authors.affiliation: Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton / Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust / Southampton NIHR Respiratory Biomedical Research Centre, University of Southampton, Room CE.93, Mailpoint 24, Tremona Road, Southampton, Hampshire SO16 6YD, UK; NIAA Health Services Research Centre, Royal College of Anaesthetists, Red Lion Square, London, WC1R 4SG, UK; UCLH Surgical Outcomes Research Centre / UCLH/UCL NIHR Biomedical Research Centre, London, University College London Hospitals NHS Foundation Trust, 149 Tottenham Court Road, London, W1T 7DN, UK. Electronic address: mike.grocott@soton.ac.uk.
authors.forename: Michael P W
authors.initials: MP
authors.lastname: Grocott
authors.affiliation: NIAA Health Services Research Centre, Royal College of Anaesthetists, Red Lion Square, London, WC1R 4SG, UK; UCLH Surgical Outcomes Research Centre / UCLH/UCL NIHR Biomedical Research Centre, London, University College London Hospitals NHS Foundation Trust, 149 Tottenham Court Road, London, W1T 7DN, UK; Centre for Anaesthesia, UCL, Gower Street, London, WC1E 6BT, UK.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Mythen
mesh_terms: D000758:Anesthesia / Q000592:standards*; D000776:Anesthesiology / Q000592:standards*; D006801:Humans; D019990:Perioperative Care / Q000592:standards*; D058996:Quality Improvement / Q000592:standards*; D006113:United Kingdom
keywords: Anesthesia; Anesthesiology; Cost-effectiveness; Health economics; Perioperative medicine; Perioperative physician; Value; Value proposition