A method of costing anaesthetic practice

Area of Science:

• Anesthesiology
• Healthcare Economics

Background:

• Accurate cost analysis of anaesthetic practice is essential for efficient healthcare resource allocation.
• General anaesthesia costs encompass various components, including personnel, equipment, consumables, and patient-specific factors.

Purpose of the Study:

• To identify and quantify the primary cost drivers in elective general anaesthetic practice.
• To compare different methods of costing anaesthesia, including a prospective computerized approach.

Main Methods:

• Categorized anaesthesia costs into overheads (salaries, equipment), fixed costs (pre-operative assessment, recovery care), and running costs (drugs, disposables).
• Estimated overhead costs per hour and fixed costs per patient using 1993 data.
• Costed four sample anaesthetics using two methods: detailed itemization of consumables versus a computerized charge sheet.

Main Results:

• Overhead costs, including consultant anaesthetist and technical assistant salaries, monitoring, and anaesthetic machines, were estimated at £45.05/hour.
• Fixed costs for pre-operative assessment and recovery nursing care amounted to £20.60 per patient.
• The majority of total anaesthesia cost (approx. 70%) comprised anaesthetist, overhead, and postoperative care, with running costs forming the remainder.
• A 30-minute delay in operating session start incurred a cost of £27.30, exceeding the cost of 2 hours of propofol infusion anaesthesia.
• Close agreement was found between the detailed costing method and the computerized charge sheet method.

Conclusions:

• The cost structure of general anaesthesia is significantly influenced by personnel salaries, equipment, and patient-related fixed expenses.
• Running costs, including drugs and disposable items, constitute a smaller but variable portion of the total anaesthetic expenditure.
• Operating session delays represent a substantial and avoidable cost in anaesthetic practice.
• A computerized charge sheet system offers a viable and accurate method for prospective anaesthesia costing.