The results and methodological concerns about pharmaco-economic evaluation in anesthesia

Abstract

Background Globalization and profitable health (cost/benefit) requires pharmacoeconomic evaluation of the costs in relation to effectiveness of the methods of treatment. The objective of this study was to analyze the cumulative costs of anesthesia in all surgical disciplines using the Activity-Based Costing (ABC) analysis. Methods This work is a part of Phase IV clinical study. Retrospectively, for 2006, direct costs of anesthesia services were calculated: (1) personnel costs (salaries), (2) drugs and supplies, (3) other costs (analysis and apparatus) in the Institute of Anesthesiology and Resuscitation, Clinical Center of Serbia. The research group included all anesthetized patients of both genders and ofall ages. Summary data documented in the anesthesia department and databases of the Clinical Center of Serbia and the Republic Institute of Health Insurance were used. Numerical data were calculated and analyzed by computer programs Microsoft Office Excel 2003 and SPSS for Windows. Results The results of direct costs showed that personnel costs accounted for 40%, medicines and supplies-31.80% and other costs-28.20% of the funds. Anesthesia costs accounted for 10% (ABC analysis) of direct costs. Methodological dilemmas were related to the inaccuracy of anesthetic and surgical protocols, the classification of anesthetic and surgical services and the imperfection of computer data entry software. Basic hospital activities information should be more specific and precise. Clinical protocols of the anesthetized patients should be connected better with the Admission department, Intensive care units, Day surgical hospital and other departments. Database of the clinical drug pathway, Clinical protocols, Accounting Information Systems, and Hospital Management Information Systems should be precise, specific and managed in a better way. Conclusions The costs of local and general anesthesia procedures are objectively low and numerous, what may be objectified by this pharmacoeconomic analysis. Those insufficiently informed call for "rationalization". The costs of drugs and supplies are real while all other costs are agreed upon, and accordingly, there is no possibility of cutting down the expenses within so small and restrictive health budget. The change of budget dynamics and education of control staff could be helpful.

A study of the direct costs of anesthesiology and reanimatology in Clinical center Serbia

“…For this reason, we have shown precise data on the average number of days of surgical and anesthetized patients in ICU and then gave up on continuing to follow these data. More precise databases of anesthesia associated with precise surgical databases would provide accurate information on the volume and value of these services [19,20].…”

“…Expenses of anesthesiology have been interpreted since 1990 as a cost of clinical support [13] to surgery as the center of clinical consumption. For the year 2006, the cost of anesthesia would increase the cost of surgery by 10% [6, 13,29]. We did not have the available data for 2015.…”

Anesthesia today with the economic and clinical aspects

“…In order to understand the functioning of real RHIF support of hospital health care in the fi eld of anesthesia, it was necessary, and interesting to determine the relationship between the elements of direct costs derived from clinical trials, with a package of anesthesia services refunded by RHIF [6,7,8]. We compared the linear model data of the direct costs of "unit costs" obtained from the HIF price list.…”

“…Th e reason is, according to our opinion, organizational division of neurosurgical services in the two clinics, Neurosurgical and Emergency Center. Organization of the Department of Anesthesiology and ICU and way of fi nancing health care aff ect costs [4,5,6] As a measure of the eff ectiveness or cost eff ectiveness are used the scores of improved life quality related to health. Because its key constraint is one-dimensional, we analyzed patient treatment satisfaction (eff ectiveness of the fi nal outcome).…”

“…Because its key constraint is one-dimensional, we analyzed patient treatment satisfaction (eff ectiveness of the fi nal outcome). Medical services were satisfi ed with 73% of anesthetized surgical patients [6], according to the survey which formed part of the program for monitoring and improving the quality of work in health institutions HIF [6] Th e sequence of the analysis. Personnel costs are fi xed, direct costs, which do not depend on the number of patients, and are charged on the basis of the Regulation on the coeffi cients in public services [9].…”