Costs averted with cardiac surgery CME could be substantial

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It pays to invest in continuing medical education (CME), according to a predictive model applied to cardiac and thoracic surgeries. Costs averted from bleeding-related complications and reoperation for bleeding were substantial, even when a modest number of surgeons incorporated lessons into practice.

Assessing the economic impact of CME activities in a single network or closed system may be feasible but trying to measure that more globally is a challenge. In a study published online June 16 in the Journal of Continuing Education in the Health Professions, senior author Victor Ferraris, MD, PhD, of the University of Kentucky in Louisville, and colleagues developed and tested a computer model, the Outcomes Impact Analysis, to estimate potential healthcare savings from CME participation.

The authors used Society of Thoracic Surgeons activities from 2012 and 2013 for their study. The first activity was a certified CME symposium on the prevention of bleeding-related complications using evidence-based guidelines. The second activity included an economic impact analysis from the 2012 event. Participants completed an evaluation that asked them to gauge how committed they were to change after the CME activity.

The model predicted that the educational activities would decrease operative bleeding-related complications and reoperation for bleeding by 2 percent and 1.5 percent, respectively. The base case had three of 10 CME participants applying what they learned into practice.

They set up two models: one based on a retrospective database of 103,826 cardiac operations and 142,533 noncardiac thoracic operations; and the other from several studies on 150,021 CABG procedures. For each model, they calculated estimated costs and incidence rates for bleeding-related complications and reoperation for bleeding.

Costs included only direct medical costs and were adjusted to 2012 dollars.

A base case, probabilistic sensitivity analysis showed a mean savings of more than $1.5 million for bleeding-related complications with cardiac surgeries; more than $2.7 million for bleeding-related complications with thoracic surgeries; and more than $2.2 million for reoperation for bleeding with CABG procedures. In the first model, they reported costs savings when as few as one in 10 surgeons implemented lessons into practice.

“While the OIA [Outcomes Impact Analysis] model does not fulfill the crucial need to assess knowledge, competence, and performance, it adds to the complement of outcomes measures by providing a novel and additional manner of evaluating the impact of CME,” they wrote.