Perioperative Surgical Home Essay

INTRODUCTION:
In health delivery system, one common goal for all providers, doctors and administrators is to provide high quality health care services at low costs. But in the United States, health care spending has increased drastically, but outcomes are not efficient. In the recent study conducted by common wealth fund shows that United States health care spending is 50 percent more when compared to 13 top nations in the world. [1] This report also shows that despite of having high health care expenditure in the United States, the health care outcomes are worse when compared to other countries whose health expenditure is low. To address these problems and improve outcomes, patient safety and satisfaction, in the field of surgery the American

Later in 2002 American academy of pediatrics extended this model to include 37 specialties and in 2007 different physician associations collaboratively proposed the principles of patient centered medical homes. [2] Based on this model in 2006, American society of anesthesiologist proposed similar model, perioperative surgical home model in the field of surgery for achieving triple aims; improving patient health care and providing quality health care at low costs. [2]However these concepts have evolved two decades earlier their popularity has increased only after the implementation of affordable care act in 2010 as it introduced the concept of Accountable care organizations which requires different healthcare providers to work collaboratively to provide quality healthcare services at low costs. Similar to perioperative surgical homes, enhanced recovery after surgery model (ERAS) is popular outside United States.

According to agency of health care research and quality it is estimated that almost one third of health care spending is due to inpatient surgical procedures and it also estimates that average hospital costs has been increased from $ 9,100 in 2003 to $11,000 in 2013. [4] Some major reasons for this increase in costs includes lack of coordination, risk associated with complicated surgical procedures, poor patient engagement in decision making, quality requirements and etc. The perioperative surgical homes are very effective in solving these problems and achieve better surgical outcomes as it is a coordinated care which is led by multi specialty physicians who provides continuum of care to patients from the time of decision to 30 days after discharge of the patient i.e., it is incorporated in to include all three phases of surgery; perioperative, intra-operative and postoperative