Preadmission Testing of Surgical Outpatients

This research investigates the preadmission testing of outpatient surgical patients. The purpose of the investigation is to evaluate preadmission testing as a means of (1) enhancing the quality of care delivered, (2) reducing post operative recovery times, and (3) improving the cost effectiveness of the outpatient surgical program.

Preadmission testing for outpatient surgical patients involves a number of different activities. Included in the process are the (1) performance of necessary pre-surgery medical tests and procedures, (2) origination and/or updating of patient medical records, (3) origination and/or updating of patient administrative/financial records, (4) scheduling of resources required to perform the surgical procedure, (5) education of patients with respect to the surgical procedure and recovery, and (6) final assessment of the patient as a viable candidate for outpatient surgery (Squibb, 1988; Barron, 1987; Anderson, & Zimbra, 1986; Worley, 1986; Connaway, & Blackledge, 1986; Burn, 1979).

In this review, literature is considered with respect to various aspects of the preadmission testing process, and with respect to the relationships between preadmission testing and factors included in the purpose of this study. The findings of the literature review are presented in three separate discussions. The topics of these discussions are (1) outpatient surgery and preadmission testing, (2) preadmission testing and the cost effectiveness of outpatient su

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health care delivered by providers to patients will also be decreased. Of even greater potential significance is the strong probability that the use of DRG procedures to reduce costs will cause many providers to withdraw their services from Medicare and Medicaid recipients (Young, 1985). Studies of DRG applications indicate that actual delivery costs will be under funded by significant levels, when the procedures are employed (Dimick, Potts, Charles, Wayne, & Reed, 1986). One study suggested that as many as 90 percent of the most common surgical procedures would become unprofitable under a DRGbased reimbursement system (Munoz, Margolis, & Wise, 1986). Meyer (1986) suggested that the use of DRG in reimbursement decisions will eventually lead the health care professions from being service/mission oriented to being production/business oriented. When patients become products, the quality of health care may be expected to deteriorate. An effective preadmssion testing program "eliminates the costly duplication of tests . . . that have already been done in the doctor's office" (Thompson, 1984). The procedure also saves both patient and staff time (Barron, 1987). Potential savings related to the combination of prea

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