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March 21, 2012

Assessing the Value of “Discretionary” Clinical Care: The Case of Anesthesia Services for Endoscopy

Author Affiliations

Author Affiliations: Department of Anesthesiology and Critical Care, Perelman School of Medicine, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.

JAMA. 2012;307(11):1200-1201. doi:10.1001/jama.2012.317

As societal desire to bend the health care cost curve mounts, there is increasing attention to determining the appropriateness and value of clinical interventions. Procedures and other types of tests performed in settings not deemed appropriate by relevant professional societies raise concern about low value and unnecessary spending.1 It is postulated that the magnitude of inappropriate use is such that reduction of low value care and elimination of no value care could lead to a marked reduction in overall health care spending. In this context, the study reported in this issue of JAMA by Liu and colleagues evaluating the provision of anesthesia care for low-risk patients undergoing colonoscopy and endoscopic procedures in the United States deserves careful consideration.2

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