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Evidence to Improve Care

Preoperative Consultations


Ontario Health Technology Advisory Committee Recommendations

  • province-wide assessment to understand variation across hospitals and other healthcare settings in how preoperative care is being organized and arranged to meet patients’ needs and taking into account duplication in care pathways

  • validating screening questionnaires in a variety of hospital settings to address heterogeneity, such as research hospitals, large and small community hospitals, rural, urban, etc. This would ensure that patients who are in need of consultations are appropriately screened.

Read the full OHTAC Recommendation report



Preoperative consultations are meant to give doctors details if patients have more than one disease; to find out whether more tests are needed; to get patients in the best shape possible before surgery; to discuss care before, during and after surgery; and to delay or cancel surgery if patients are not well enough.

Preoperative anesthesia consultations have increased in Ontario from 19% in 1994 to 53% in 2003. But rates for medical consultations have remained about the same. In fiscal year 2011/12 there were about 43,000 preoperative consultations by anesthesiologists and 20,000 preoperative consultations by internal medicine specialists.


Health Quality Ontario Reviews Preoperative Consultations

Most preoperative consultations are in hospital clinics at least two days before surgery to make sure patients are ready. Preoperative consultations for noncardiac surgeries do not involve operations on the heart. Patients who receive consultations are more likely to be older and have more health problems.


Preoperative Consultations: A Rapid Review (PDF)
March 2014


Related Resources

Preoperative Cardiac Stress Tests for Noncardiac Surgery: OHTAC Recommendation (PDF)
March 2014


Preoperative Resting Echocardiography for Noncardiac Surgery: OHTAC Recommendation (PDF)
March 2014


Preoperative Cardiac Stress Tests for Noncardiac Surgery: A Rapid Review (PDF)
March 2014


Preoperative Resting Echocardiography for Noncardiac Surgery: A Rapid Review (PDF)
March 2014


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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: Relevant language in the Schedule of Benefits for Physician Services has been updated to ensure preoperative consultations are publicly funded when medically necessary.




Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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