[Cost control in anesthesiology--regulating net costs exemplified by anesthetics]

German hospitals are beginning to feel more and more pressure due to rising costs in health care. These are due to continuous increase in health care expenditure and decrease in state insurance contributions. A change in the state insurance system (GKV) is well and truly overdue; the source of income needs to be increased by either raising the compulsory insurance wage base or making other forms of income liable for insurance contributions. Unfortunately, the government is still reluctant to take action. The ruling coalition feels that it is better to limit the increase in expenditure on hospital care by introducing a case-related payment system. Unfortunately, they do not recognize that the main reason for the increase in health care expenditure is the growing medical potential and the higher morbidity of an, on average, older population. These cuts in financial means demand an efficient allocation of the available funds. As far as hospital in-patient care is concerned, this means that hospitals need to reconsider their expenditure and that economic success is dependent on their potential to recognize ways of reducing overall costs. This article illustrates that before the "Diagnosis Related Groups" (DRG) become effective in 2003, one needs to establish the cost price of individual hospital cases. The economic principles of cost-benefit ratios and methods to prevent cost inflation are presented. The methods of making a cost-effectiveness analysis of anaesthetic costs are explained in detail. The aim of this paper is to give the clinician a better understanding of cost management and to motivate staff to initiate cost-control studies.