Alex Macario
Stanford University, USA

Alex Macario is a Professor of anesthesiology and, by courtesy, of health research and policy at the Stanford University School of Medicine. He completed his undergraduate, medical school, and business school training at the University of Rochester. He was trained in anesthesiology at Stanford University and was a Chief Resident. He then completed a fellowship in heath services research. Dr. Macario is interested in the economics of health care, in particular the tradeoffs between costs and outcomes for patients having surgery and anesthesia. Dr. Macario has completed internationally recognized studies on the management of the operating room suite, as well as pioneering work on the cost effectiveness of drugs and devices. He is a Director of a fellowship in the management of perioperative services, a postgraduate fellowship program which trains one to two physicians per year in leadership, entrepreneurship, and management science with special attention to the delivery of surgical care. Dr. Macario is also a Program Director for the Stanford Anesthesia Residency which has more than 60 housestaff. Dr. Macario has also authored A Sabbatical in Madrid: A Diary of Spain, an award winning travel memoir.

Biography Updated on 21 May 2007

Articles in Scholarly Journals [Incomplete List]

  1. Identification of systematic underestimation (bias) of case durations during case scheduling would not markedly reduce overutilized operating room time?
    Journal of Clinical Anesthesia, vol. 19, no. 3, pp. 198–203, 2007
  2. Hospitalization Costs of Total Knee Arthroplasty With a Continuous Femoral Nerve Block Provided Only in the Hospital Versus on an Ambulatory Basis: A Retrospective, Case-Control, Cost-Minimization Analysis
    Regional Anesthesia and Pain Medicine, vol. 32, no. 1, pp. 46–54, 2007
  3. Initial Clinical Evaluation of a Handheld Device for Detecting Retained Surgical Gauze Sponges Using Radiofrequency Identification Technology
    Archives of Surgery, vol. 141, no. 7, pp. 659–662, 2006
  4. Is There Value in Obtaining a Patient???s Willingness to Pay for a Particular Anesthetic Intervention?
    Anesthesiology, vol. 104, no. 5, pp. 906–909, 2006
  5. Are Your Hospital Operating Rooms ???Efficient????
    Anesthesiology, vol. 105, no. 2, pp. 237–240, 2006
  6. Factors affecting supply and demand of anesthesiologists in Western Europe
    Current Opinion in Anaesthesiology, vol. 19, no. 2, pp. 207–212, 2006
  7. The drive for operating room efficiency will increase quality of patient care
    Current Opinion in Anaesthesiology, vol. 19, no. 2, pp. 171–176, 2006
  8. Staffing and case scheduling for anesthesia in geographically dispersed locations outside of operating rooms
    Current Opinion in Anaesthesiology, vol. 19, no. 4, p. 453???458, 2006
  9. Systematic Literature Review of Spinal Decompression Via Motorized Traction for Chronic Discogenic Low Back Pain
    Pain Practice, vol. 6, no. 3, pp. 171–178, 2006
  10. BMC Anesthesiology, vol. 6, no. 1, p. 6, 2006
  11. BMC Medical Informatics and Decision Making, vol. 6, no. 1, p. 15, 2006
  12. Scheduling Elective Pediatric Procedures That Require Anesthesia: The Perspective of Parents
    Anesthesia & Analgesia, vol. 103, no. 6, pp. 1426–1431, 2006
  13. Patient Preferences for Anesthesia Outcomes Associated with Cesarean Delivery
    Anesthesia & Analgesia, vol. 101, no. 4, pp. 1182–1187, 2005
  14. Quantifying Effect of a Hospital’s Caseload for a Surgical Specialty on That of Another Hospital Using Multi-Attribute Market Segments
    Health Care Management Science, vol. 8, no. 2, pp. 121–131, 2005
  15. Cost-Effectiveness of a Trial of Labor After Previous Cesarean Delivery Depends on the A Priori Chance of Success
    Clinical Obstetrics and Gynecology, vol. 47, no. 2, pp. 378–385, 2004
  16. When to Release Allocated Operating Room Time to Increase Operating Room Efficiency
    Anesthesia & Analgesia, pp. 758–762, 2004
  17. Operating Room Utilization Alone Is Not an Accurate Metric for the Allocation of Operating Room Block Time to Individual Surgeons with Low Caseloads
    Anesthesiology, vol. 98, no. 5, pp. 1243–1249, 2003
  18. BMC Health Services Research, vol. 3, no. 1, p. 1, 2003
  19. Economics of One-Stage Versus Two-Stage Bilateral Total Knee Arthroplasties
    Clinical Orthopaedics and Related Research, vol. 414, pp. 149–156, 2003
  20. How to Release Allocated Operating Room Time to Increase Efficiency: Predicting Which Surgical Service Will Have the Most Underutilized Operating Room Time
    Anesthesia & Analgesia, vol. 96, no. 2, pp. 507–512, 2003
  21. Physicians' perceptions of minimum time that should be saved to move a surgical case from one operating room to another: internet-based survey of the membership of the association of anesthesia clinical directors (aacd)
    Journal of Clinical Anesthesia, vol. 15, no. 3, pp. 206–210, 2003
  22. The pharmacy cost of delivering postoperative analgesia to patients undergoing joint replacement surgery
    The Journal of Pain, vol. 4, no. 1, pp. 22–28, 2003
  23. What are the Most Important Risk Factors for a Patient???s Developing Intraoperative Hypothermia?
    Anesthesia & Analgesia, vol. 94, no. 1, pp. 215–220, 2002
  24. Changing Allocations of Operating Room Time From a System Based on Historical Utilization to One Where the Aim is to Schedule as Many Surgical Cases as Possible
    Anesthesia & Analgesia, vol. 94, no. 5, pp. 1272–1279, 2002
  25. Development of an Appropriate List of Surgical Procedures of a Specified Maximum Anesthetic Complexity to Be Performed at a New Ambulatory Surgery Facility
    Anesthesia & Analgesia, vol. 95, no. 1, pp. 78–82, 2002
  26. Technology and Computing in the Surgical Suite: Key Features of an OR Management Information System and Opportunities for the Future
    Anesthesia & Analgesia, vol. 95, no. 4, pp. 1120–1121, 2002
  27. International Anesthesiology Clinics, vol. 40, no. 2, pp. 1–16, 2002
  28. Economic evaluation of noncontact normothermic wound therapy for treatment of pressure ulcers
    Expert Review of Pharmacoeconomics Outcomes Research, vol. 2, no. 3, pp. 211–217, 2002
  29. Economic Considerations Related to Providing Adequate Pain Relief for Women in Labour
    PharmacoEconomics, vol. 20, no. 5, pp. 305–318, 2002
  30. The Impact on Revenue of Increasing Patient Volume at Surgical Suites with Relatively High Operating Room Utilization
    Anesthesia and Analgesia, pp. 1215–1221, 2001
  31. Hospital Profitability per Hour of Operating Room Time Can Vary Among Surgeons
    Anesthesia & Analgesia, vol. 93, no. 3, pp. 669–675, 2001
  32. Ketorolac in the Era of Cyclo-Oxygenase-2 Selective Nonsteroidal Anti-Inflammatory Drugs: A Systematic Review of Efficacy, Side Effects, and Regulatory Issues
    Pain Medicine, vol. 2, no. 4, pp. 336–351, 2001
  33. Can peri-operative quality be maintained in the drive for operating room efficiency? An American perspective
    Best Practice & Research Clinical Anaesthesiology, vol. 15, no. 4, pp. 607–619, 2001
  34. The surgical suite meets the new health economy
    Journal of the American College of Surgeons, vol. 192, no. 6, pp. 768–776, 2001
  35. Variation in practice patterns of anesthesiologists in California for prophylaxis of postoperative nausea and vomiting
    Journal of Clinical Anesthesia, vol. 13, no. 5, pp. 353–360, 2001
  36. Cost-effectiveness of a trial of labor after previous cesarean
    Obstetrics & Gynecology, vol. 97, no. 6, pp. 932–941, 2001
  37. Quantitative description of the workload associated with airway management procedures
    Journal of Clinical Anesthesia, vol. 12, no. 4, pp. 273–282, 2000
  38. Analgesia for Labor Pain
    Anesthesiology, vol. 92, no. 3, pp. 841–850, 2000
  39. Scheduling Surgical Cases into Overflow Block Time??? Computer Simulation of the Effects of Scheduling Strategies on Operating Room Labor Costs
    Anesthesia & Analgesia, vol. 9, no. 4, pp. 980–988, 2000
  40. A Retrospective Examination of Regional Plus General Anesthesia in Children Undergoing Open Heart Surgery
    Anesthesia & Analgesia, vol. 90, no. 5, pp. 1020–1024, 2000
  41. What Is the Relative Frequency of Uncommon Ambulatory Surgery Procedures Performed in the United States with an Anesthesia Provider?
    Anesthesia & Analgesia, vol. 90, no. 6, pp. 1343–1347, 2000
  42. Enterprise-Wide Patient Scheduling Information Systems to Coordinate Surgical Clinic and Operating Room Scheduling Can Impair Operating Room Efficiency
    Anesthesia & Analgesia, pp. 617–626, 2000
  43. Statistical Method to Evaluate Management Strategies to Decrease Variability in Operating Room Utilization
    Anesthesiology, vol. 91, no. 1, pp. 262–274, 1999
  44. Which Algorithm for Scheduling Add-on Elective Cases Maximizes Operating Room Utilization?
    Anesthesiology, vol. 91, no. 5, p. 1491, 1999
  45. Forecasting Surgical Groups??? Total Hours of Elective Cases for Allocation of Block Time
    Anesthesiology, vol. 91, no. 5, p. 1501, 1999
  46. Relying solely on historical surgical times to estimate accurately future surgical times is unlikely to reduce the average length of time cases finish late
    Journal of Clinical Anesthesia, vol. 11, no. 7, pp. 601–605, 1999
  47. Do clinical pathways improve efficiency?
    Seminars in Anesthesia, Perioperative Medicine and Pain, vol. 18, no. 4, pp. 281–288, 1999
  48. MANAGEMENT OF THE OPERATING ROOMA New Practice Opportunity for Anesthesiologists
    Anesthesiology Clinics of North America, vol. 17, no. 2, pp. 365–394, 1999
  49. What can the postanesthesiacare unit manager do to decrease costs in the postanesthesia care unit?*
    Journal of PeriAnesthesia Nursing, vol. 14, no. 5, pp. 284–293, 1999
  50. Journal of Clinical Monitoring and Computing, vol. 15, no. 3/4, pp. 153–162, 1999
  51. Decrease in Case Duration Required to Complete an Additional Case During Regularly Scheduled Hours in an Operating Room Suite
    Anesthesia & Analgesia, vol. 88, no. 1, pp. 72–76, 1999
  52. Selecting Double-Lumen Tubes for Small Patients
    Anesthesia & Analgesia, vol. 88, no. 2, p. 466, 1999
  53. Computer Simulation to Determine How Rapid Anesthetic Recovery Protocols to Decrease the Time for Emergence or Increase the Phase I Postanesthesia Care Unit Bypass Rate Affect Staffing of an Ambulatory Surgery Center
    Anesthesia & Analgesia, vol. 88, no. 5, pp. 1053–1063, 1999
  54. Which Clinical Anesthesia Outcomes Are Both Common and Important to Avoid? The Perspective of a Panel of Expert Anesthesiologists
    Anesthesia & Analgesia, vol. 88, no. 5, pp. 1085–1091, 1999
  55. Another Use of a Bronchoscopic Swivel Adapter
    Anesthesia & Analgesia, vol. 88, no. 5, pp. 1187–1188, 1999
  56. An Operating Room Scheduling Strategy to Maximize the Use of Operating Room Block Time
    Anesthesia & Analgesia, vol. 89, no. 1, pp. 7–20, 1999
  57. Which Clinical Anesthesia Outcomes Are Important to Avoid? The Perspective of Patients
    Anesthesia & Analgesia, vol. 89, no. 3, p. 652, 1999
  58. A Strategy for Deciding Operating Room Assignments for Second-Shift Anesthetists
    Anesthesia & Analgesia, vol. 89, no. 4, p. 920, 1999
  59. Postoperative epidural injection of saline can shorten postanesthesia care unit time for knee arthroscopy patients*1
    Regional Anesthesia and Pain Medicine, vol. 23, no. 3, pp. 247–251, 1998
  60. Setting Performance Standards for an Anesthesia Department
    Journal of Clinical Anesthesia, vol. 10, no. 2, pp. 166–175, 1998
  61. Hospital profitability for a surgeon's common procedures predicts the surgeon's overall profitability for the hospital
    Journal of Clinical Anesthesia, vol. 10, no. 6, pp. 457–463, 1998
  62. Computer simulation of changes in nursing productivity from early tracheal extubation of coronary artery bypass graft patients
    Journal of Clinical Anesthesia, vol. 10, no. 7, pp. 593–598, 1998
  63. Obstetric Postanesthesia Care Unit Stays
    Anesthesiology, vol. 89, no. 6, pp. 1559–1565, 1998
  64. The Effect of a Perioperative Clinical Pathway for Knee Replacement Surgery on Hospital Costs
    Anesthesia & Analgesia, vol. 86, no. 5, pp. 978–984, 1998
  65. Bilateral Vocal Cord Paralysis After Radical Cystectomy in a Patient with a History of Bulbar Polio
    Anesthesia & Analgesia, vol. 85, no. 5, pp. 1171–1172, 1997
  66. Hospital Costs and Severity of Illness in Three Types of Elective Surgery
    Anesthesiology, vol. 86, no. 1, pp. 92–100, 1997
  67. Economics of Anesthesia Care
    Anesthesiology, vol. 86, no. 5, pp. 1018–1019, 1997
  68. Does Early Extubation ("Fast-tracking") of Coronary Artery Bypass Graft Surgery Patients Truly Decrease Perioperative Costs?
    Anesthesiology, vol. 87, no. 1, p. 181, 1997
  69. Tracheal Diameter Predicts Double-Lumen Tube Size
    Anesthesia & Analgesia, vol. 82, no. 4, pp. 861–864, 1996
  70. Improved Outcome with Chronic Subcutaneous Infusion of Ondansetron for Intractable Nausea and Vomiting
    Anesthesia & Analgesia, vol. 83, no. 1, pp. 194–195, 1996
  71. Fuzzy logic: Theory and medical applications
    Journal of Cardiothoracic and Vascular Anesthesia, vol. 10, no. 6, pp. 800–808, 1996
  72. Spinal Versus Epidural Anesthesia for Cesarean Section
    Anesthesia & Analgesia, vol. 80, no. 4, pp. 709–712, 1995
  73. Spinal Versus Epidural Anesthesia for Cesarean Section
    Anesthesia & Analgesia, vol. 81, no. 6, pp. 1318–1319, 1995
  74. Pain outcomes after thoracotomy: Lumbar epidural hydromorphone versus intrapleural bupivacaine
    Journal of Cardiothoracic and Vascular Anesthesia, vol. 9, no. 5, pp. 534–537, 1995
  75. Modified bronchocath double-lumen tube
    Journal of Cardiothoracic and Vascular Anesthesia, vol. 9, no. 6, pp. 784–785, 1995
  76. Reply
    Journal of Clinical Anesthesia, vol. 7, no. 2, pp. 175–176, 1995
  77. The demographics of inpatient pediatric anesthesia: Implications for credentialing policy,
    Journal of Clinical Anesthesia, vol. 7, no. 6, pp. 507–511, 1995
  78. A Cost Analysis of the Laryngeal Mask Airway for Elective Surgery in Adult Outpatients
    Anesthesiology, vol. 83, no. 2, pp. 250–257, 1995
  79. Where Are the Costs in Perioperative Care?
    Anesthesiology, vol. 83, no. 6, pp. 1138–1144, 1995
  80. Comparison of Estimated Variable Costs Is a Surrogate for Actual Cost Experience
    Anesthesiology, vol. 83, no. 6, p. 1387, 1995
  81. Elimination of 12 and 24 Fr Esophageal Stethoscopes from Anesthetic Practice (An Attempt at Cost Containment)
    Anesthesia & Analgesia, vol. 79, no. 2, p. 393, 1994