Valuing the work performed by anesthesiology residents and the financial impact on teaching hospitals in the United States of a reduced anesthesia residency program size

Michael A. Pisetsky, David Lubarsky, Bruce P. Capehart, Catherine K. Lineberger, J. G. Reves

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

We performed a financial analysis at a large university tertiary care hospital to determine the incremental cost of replacing its anesthesiology residents with alternative dependent providers (i.e., certified registered nurse anesthetists in the operating room, advanced practice nurses and physician assistants outside the operating room). The annual average net cost of an anesthesiology resident during a 3-yr residency is approximately $38,000, and residents performed an average of $89,000 of essential clinical work annually based on replacement costs. The incremental cost (replacement labor cost minus net resident cost) to replace all essential clinical duties performed by an anesthesiology resident at Duke University Medical Center and affiliated hospitals is approximately $153,000 throughout 3 yr of clinical anesthesiology training. If this approach were applied nationwide, incremental costs of substitution would range from $36,000,000 to $93,000,000 per year. We conclude that maintaining clinical service in the face of anesthesiology residency reductions can have a marked impact on the overall cost of providing anesthesiology services in teaching hospitals. Simply replacing residents with alternate nonphysician providers is a very expensive option. Implications: We sought to calculate the financial burden resulting from a decreased number of anesthesiology residents. Replacing each resident's essential clinical work with similarly skilled healthcare providers would cost hospitals approximately $153,000 over the course of a 3- yr residency. Varying projections yield future nationwide costs of $36,000,000 to $93,000,000 per year. Simply replacing residents with alternate nonphysician providers is a very expensive option.

Original languageEnglish (US)
Pages (from-to)245-254
Number of pages10
JournalAnesthesia and Analgesia
Volume87
Issue number2
DOIs
StatePublished - Aug 19 1998
Externally publishedYes

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Anesthesiology
Internship and Residency
Teaching Hospitals
Anesthesia
Costs and Cost Analysis
Operating Rooms
Nurses
Nurse Anesthetists
Physician Assistants
Hospital Costs
Tertiary Healthcare
Tertiary Care Centers
Health Personnel

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Valuing the work performed by anesthesiology residents and the financial impact on teaching hospitals in the United States of a reduced anesthesia residency program size. / Pisetsky, Michael A.; Lubarsky, David; Capehart, Bruce P.; Lineberger, Catherine K.; Reves, J. G.

In: Anesthesia and Analgesia, Vol. 87, No. 2, 19.08.1998, p. 245-254.

Research output: Contribution to journalArticle

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