Korean J Anesthesiol.  2018 Jun;71(3):175-181. 10.4097/kja.d.18.27182.

Perioperative surgical home: a new scope for future anesthesiology

• Kwon MA

• KMID: 2413526
• DOI: http://doi.org/10.4097/kja.d.18.27182

Abstract

The health care system is changing from "˜pay for volume' to "˜pay for value.' These changes are turning health care delivery into a more cost-effective and coordinated care setup that drives hospitals to lower costs and greater quality gains. The present perioperative care service in Korea has proven to be costly, fragmented, and neither evidence-based nor patient-centered. Recently, a new concept of a perioperative care model termed perioperative surgical home (PSH) has been proposed. The PSH is a patient-centered, team-based, and coordinated perioperative care setup, composed of the head anesthesiologist-perioperativist in tandem with dedicated nurse practitioners and other PSH team doctors. All pre-, intra-, and postoperative patient care functions are performed by a single PSH team, not several different departments. The PSH care extends from the decision to operate till 30 days post-discharge. Several evidence-driven perioperative strategies for reducing postoperative complications and shortening hospital stay can be adapted to each specific hospital situation, rather than strictly applying any given strategies. With the PSH, patients are more satisfied and experience better outcomes. It is also a good hospital business model. The expanded role of anesthesiologists in the PSH has the potential to invigorate the specialty.

Keyword

Delivery of health care; Health care costs; Length of stay; Medical errors; Perioperative care; Value-based purchasing

MeSH Terms

Anesthesiology*
Commerce
Delivery of Health Care
Head
Health Care Costs
Humans
Korea
Length of Stay
Medical Errors
Nurse Practitioners
Patient Care
Perioperative Care
Postoperative Complications
Value-Based Purchasing