As discussed in the British Journal of Anaesthesia, the fundamental purpose of healthcare is to achieve good health outcomes for patients (Murphy, 2012). Researchers measure and publish clinical outcomes of healthcare services to ultimately improve their quality and establish a minimum standard of care. However, collecting data on such performance measurements renders ample costs, specifically pertaining to anesthesia services. Many believe that measuring performance of healthcare providers such as anesthesiologists, CRNAs and others is not feasible due to the large amount of accurate, high quality data that is necessary for national comparisons, the lack of which results in flawed analyses and data misrepresentation. The current incapacity to precisely, collectively capture health outcomes for anesthesia patients in addition to the misuse of data, like misrepresentation, are some examples of the costs of collecting data on healthcare performance measurement. Because individuals are seldom provided the appropriate context to interpret such measures, an information discrepancy in healthcare performance measurement arises, leaving patients unable to determine what information is relevant to their care. This discrepancy, otherwise known as healthcare asymmetry, can adversely affect professional attitudes and patient-doctor relationships.
Because anesthesiologists, CRNAs and other anesthesia service providers provide multifaceted services to complex patients, despite researchers’ ability to collect process data, little information exists on patient health outcomes after the receipt of anesthesia services. One problem with measuring such outcomes is related to the fact that modern anesthesia is relatively safe, thus, mortality is not a sensitive indicator or measure of quality in healthcare performance. Further, no consensus has been established regarding how to measure perioperative anesthesia-related mortality, as its temporal definition ranges from death within 48 hours of an anesthesia procedure, to within 30 days of a procedure, among many others observed in the literature. Researchers must define quality measures needed to understand health outcomes in anesthesia practice to identify areas of need, and ultimately lessen the burdensome costs of healthcare performance measurement in regards to anesthesia services. While the healthcare system should promote accountability and transparency, efficient data collection should accurately reflect performance of anesthesiologists, CRNAs and other anesthesia services professionals, and be distributed to consumers as it is deemed relevant to understanding their care. To overcome such costs of healthcare performance measurement for anesthesiologists, CRNAs and others involved in providing anesthesia services, measures must be defined, identified and agreed upon, so as to assure consistency in national data collection, in order to determine the most efficient and effective means of care in terms of cost, risk and health outcomes for patients undergoing anesthesia services.
