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A method of costing anaesthetic practice

P J Broadway1, J G Jones

  • 1University Department of Anaesthesia, Addenbrookes Hospital, Cambridge.

Anaesthesia
|January 1, 1995
PubMed
Summary

Understanding the cost of general anaesthesia is crucial for healthcare economics. This study breaks down anaesthetic costs into overheads, fixed, and running expenses, revealing that delays significantly impact overall expenditure.

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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.

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