Editorial Views  |   March 2018
Do Anesthetic Choices Signal Quality?
Author Notes
  • From the Department of Anesthesia and Perioperative Care, the Philip R. Lee Institute for Health Policy Studies, and the San Francisco Center for Healthcare Value, University of California, San Francisco, California (C.L.C.); and the Department of Anesthesiology and Critical Care and the Department of Internal Medicine, Division of Geriatric Medicine, Perelman School of Medicine, the Leonard Davis Institute for Health Economics, and the Center for Perioperative Outcomes Research and Transformation, University of Pennsylvania, Philadelphia, Pennsylvania (M.D.N.).
  • Corresponding article on page 480.
    Corresponding article on page 480.×
  • Accepted for publication November 10, 2017.
    Accepted for publication November 10, 2017.×
  • Address correspondence to Dr. Chen: catherine.chen@ucsf.edu
Article Information
Editorial Views / Trauma / Burn Care / Quality Improvement
Editorial Views   |   March 2018
Do Anesthetic Choices Signal Quality?
Anesthesiology 3 2018, Vol.128, 429-430. doi:10.1097/ALN.0000000000002074
Anesthesiology 3 2018, Vol.128, 429-430. doi:10.1097/ALN.0000000000002074
HOW does one identify high-quality anesthetic care? Although the specialty of anesthesiology has succeeded in improving the safety and quality of care over time, with a 97% reduction in anesthesia-related deaths between 1948 and 2005, from 3.3 per 100,000 population to 1.1 per million,1,2  our ability to identify high-quality anesthesia care at the level of the individual provider or practice remains sharply limited. For example, hospitals that equate high-quality anesthesia with having high operating room efficiency may implement process measures such as the percentage of on-time first case starts to evaluate individual anesthesiologist performance, but these measures rarely have an impact on surgical outcomes.3,4  In this issue of Anesthesiology, McIsaac et al.5  present new data with potential implications for how anesthesia quality is understood and measured by exploring patient outcomes across hospitals with distinct signatures of practice based on their utilization of neuraxial versus general anesthesia.
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