Is Anesthesia Care Socioeconomically Imbalanced?

“States need to remove barriers to scope of practice for CRNAs in order to respond to the influx of millions of newly insured and Medicaid participants and assure these vulnerable populations have access to anesthesia services without overburdening the healthcare system,” said Juan Quintana, CRNA, DNP, MHS, president of AANA, in a press release.

CRNAs are already the primary providers of anesthesia in rural parts of the United States.  In some states they are the sole anesthesia professionals in nearly 100% of rural hospitals. CRNAs practice in all 50 states and provide approximately 40 million anesthetics to patients every year.

Previous studies have examined the quality and safety of care provided by CRNAs. In a 2010 study by RTI International, researchers examined nearly 500 000 individual cases and confirmed that CRNAs provide safe and high-quality care, regardless of whether they work independently or under physician supervision.2 According to another study in 2010, CRNAs are also the most cost effective providers of anesthesia in all settings where anesthesia is delivered.3


1. Liao CJ, Quraishi JA, and Jordan LM. Geographical Imbalance of Anesthesia Providers and its Impact On the Uninsured and Vulnerable Populations. Nurs Econ. 2015;33(5):263-270.

2. Dulisse B, Cromwell J. No Harm Found When Nurse Anesthetists Work Without Supervision By Physicians. Health Aff. 2010;29(8):1469-1475. doi:10.1377/hlthaff.2008.0966.

3. Hogan PF, Seifert RF, Moore CS, Simonson BE. Cost Effectiveness Analysis of Anesthesia Providers. Nurs Econ. 2010;28(3).