Are anesthesia start and end times randomly distributed? The influence of electronic records

J Clin Anesth. 2014 Jun;26(4):264-70. doi: 10.1016/j.jclinane.2013.10.016. Epub 2014 May 20.

Abstract

Study objective: To perform a frequency analysis of start minute digits (SMD) and end minute digits (EMD) taken from the electronic, computer-assisted, and manual anesthesia billing-record systems.

Design: Retrospective cross-sectional review.

Setting: University medical center.

Measurements: This cross-sectional review was conducted on billing records from a single healthcare institution over a 15-month period. A total of 30,738 cases were analyzed. For each record, the start time and end time were recorded. Distributions of SMD and EMD were tested against the null hypothesis of a frequency distribution equivalently spread between zero and nine.

Main results: SMD and EMD aggregate distributions each differed from equivalency (P < 0.0001). When stratified by type of anesthetic record, no differences were found between the recorded and expected equivalent distribution patterns for electronic anesthesia records for start minute (P < 0.98) or end minute (P < 0.55). Manual and computer-assisted records maintained nonequivalent distribution patterns for SMD and EMD (P < 0.0001 for each comparison). Comparison of cumulative distributions between SMD and EMD distributions suggested a significant difference between the two patterns (P < 0.0001).

Conclusion: An electronic anesthesia record system, with automated time capture of events verified by the user, produces a more unified distribution of billing times than do more traditional methods of entering billing times.

Keywords: Anesthesia billing; Anesthesia procedure start times; Electronic anesthesia record; End minute digit; Procedure timekeeping; Start minute digit.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Academic Medical Centers
  • Anesthesia / economics
  • Anesthesia / methods*
  • Automation
  • Cross-Sectional Studies
  • Electronic Health Records / statistics & numerical data*
  • Fees and Charges
  • Humans
  • Medical Records Systems, Computerized
  • Reimbursement Mechanisms*
  • Retrospective Studies
  • Time Factors