Financial and Operational Analysis of Non–Operating Room Anesthesia: the Wrong Way Versus the Right Way (original) (raw)
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The must of material cost rationalization in medical practice has stimulated the authors to analyze the structure of material expenses of spinal and general anesthesia on a model of arthroscopic knee surgery. The aim was to determine whether the cost of spinal anesthesia was still lower than that of general anesthesia after the introduction of expensive atraumatic needles. In addition, we were interested in the extent to which our daily practice correlated with that in industrialized countries and what were the possibilities of cost rationalization. Using retrograde analysis of two comparable groups of 40 patients each, submitted to arthroscopic knee surgery in general or spinal anesthesia, the anesthesia material expenses were divided into variable and constant expenses that are partially common to both types and partially specific for each type of anesthesia. The sums of variable and specific expenses were compared between the two types of anesthesia, amounting to 78,26 HRK for sp...
Anesthesia & Analgesia, 2001
Academic anesthesiology departments provide clinical services for surgical procedures that have longer-than-average surgical times and correspondingly increased anesthesia times. We examined the financial impact of these longer times in three ways: 1) the estimated loss in revenue if billing were done on a flat-fee system by using industry-averaged anesthesia times; 2) the estimation of incremental operating room (OR) sites necessitated by longer anesthesia times; and 3) the estimated potential gain in billed units if the hours of productivity of current anesthesia time were applied to surgical cases of average duration. Health Care Financing Administration average times per anesthesia procedure code were used as industry averages. Billing data were collected from four academic anesthesiology departments for 1 yr. Each claim billed with ASA units was included except for obstetric anesthesia care. All clinical sites that do not bill with ASA units were excluded. Base units were determined for each anesthesia procedure code. The mean commercial conversion factor (US$45 per ASA unit) for reimbursement was used to estimate the impact in dollar amounts. In all four groups, anesthesia times exceeded the Health Care Financing Administration average. The loss per group in billed ASA units if a flat-fee billing system were used ranged from 18,194 to 31,079 units per group, representing a 5% to 15% decrease (estimated billing decrease of US$818,719 to US$1,398,536 per group). The number of excess OR sites necessitated by longer surgical and anesthesia times ranged from 1.95 to 4.57 OR sites per group. The potential gain in billed units if the hours of productivity of current anesthesia time were applied to surgical cases of average duration was estimated to be from 13,273 to 21,368 ASA units. Longer-than-average anesthesia and surgical times result in extra hours or additional OR sites to be staffed and loss of potential reimbursement for the four academic anesthesiology departments. A flat-fee system would adversely affect academic anesthesiology departments. We examined the economic impact of longer-than-average anesthesia times on four academic anesthesiology departments in three ways: the estimated loss in revenue under a flat-fee system, the excess operating room sites staffed, and the potential gain in revenue if the surgeries were of average length. These results should be considered both in productivity measurements and strategies for operating room management.
Cost Effectiveness of Physician Anesthesia
2013
Introduction The question of whether anesthesiologists are cost-effective providers of anesthesia services remains an open question in the minds of some of our medical colleagues, the allied health community, the political and regulatory class, and the public. There have been recent publications that claim that there is no difference in outcomes between anesthetics delivered by anesthesiologists versus those delivered by nurse anesthetists and since nurses are paid less than physicians that anesthesiologists are not cost-effective [1-3]. In a medical environment with rapidly narrowing margins, replacing physicians with nurses could be an attractive option to some medical facilities.
Cost containment in anesthesiology: A survey of department activities
Journal of Clinical Anesthesia, 1997
To ~unq cost containment ac'tivities in anesthesiology: and to determine to what extent departments use cost pobri~s and guidelines. Design: Muil sunq. Setting: Academic and large nonacademic anesthesiolog? departments. Measurements and Main Results: 147 responding departments answrrred 20 questions. ?S% of suroqs were returned. 90 responder-c idrntijird themselves as academic departments and 57 responders as nonacademic. 73 7~ of d@artments reported pressure from hospital administmtor.c to reduce ane.sthesia ro$ts. The most common cost-saving activity, used 4 907~ of departments, is improving operating room (OR) utilization. 53% of all departments have poliries or <guidelines to contain d7ug costs, while 48% of departments have these to contain other product costs. LIepartmrnts l$orting-themselves as academic genflally reported greater-use of cost poke% (:onclusions: Anrsthrsiolo,p departments are QpPnencingpressztre to reduce costs and the majority have cost policies rind CguideLine.~ roncernlng utilization of 0R.s and anesthetic drugs. :Aradrmir anesthesiolog?; drpartmPnts may be expurimring more cost-containment pressure than nonacademic departments.
Cost-Conscious of Anesthesia Physicians is Enough? Awareness Survey
Pakistan Journal of Medical Sciences, 2015
the approval of the local ethics committee. Overall 149 anesthetists were included in the study. Participants were asked to estimate the cost of 30 products used by anesthesiology and intensive care units. Results: One hundred forty nine doctors, 45% female and 55% male, participated in this study. Of the total 30 questions the averages of cost estimations were 5.8% accurate estimation, 35.13% underestimation and 59.16% overestimation. When the participants were divided into the different groups of institution, duration of working in this profession and sex, there were no statistically significant differences regarding accurate estimation. However, there was statistically significant difference in underestimation. In underestimation, there was no significant difference between 16-20 year group and >20 year group but these two groups have more price overestimation than the other groups (p=0.031). Furthermore, when all the participants were evaluated there were no significant difference between age-accurate cost estimation and profession time-accurate cost estimation. Conclusion:Anesthesiology and intensive care physicians in this survey have an insufficient awareness of the cost of the drugs and materials that they use. The institution and experience are not effective factors for accurate estimate. Programs for improving the health workers knowledge creating awareness of cost should be planned in order to use the resources more efficiently and cost effectively,