Pradervand Mooser Michèle, Gardaz Jean-Patrice, Capt Hélène, Spahn Donat R
Du Service d'Anesthésiologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Suisse, France.
Can J Anaesth. 2002 Jun-Jul;49(6):540-4. doi: 10.1007/BF03017378.
The relative contribution of anesthesia costs to total perioperative costs is not known precisely. The goal of this prospective study was to measure the proportion of anesthesia costs relative to total hospital costs of elective laparoscopic cholecystectomy (LC) for in-patients.
With Institutional approval, the total hospital costs of elective LC for 62 ASA I-III patients were analyzed. All direct and indirect variable costs, including salaries of anesthesia and surgery teams, were obtained for each patient. Data are expressed as mean +/- SEM.
Intraoperative anesthesia costs as a percentage of the total hospital costs equaled 10.5 +/- 0.3%. Postanesthesia care unit (PACU) cost was 3.1 +/- 0.2%. The largest hospital cost category was the operating room with 37.4 +/- 0.6%. The costs attributed to the ward equaled 31.3 +/- 3%. Other costs were generated by radiology (6.2 +/- 1.1%), laboratory (5.4 +/- 0.7%), admission unit (3.4 +/- 0.2%), pharmacy (2.0 +/- 0.4%) and administration (0.7 +/- 0.1%).
Even if salaries are included, anesthesia and PACU costs (13.6%) represent a small portion only of total hospital costs. Cost savings thus may result from improving operating room efficiency and shortening of hospitalisation rather than programs aiming at lowering anesthesia costs.
麻醉费用在围手术期总费用中所占的相对比例尚不清楚。这项前瞻性研究的目的是测量住院患者择期腹腔镜胆囊切除术(LC)中麻醉费用相对于医院总费用的比例。
经机构批准,分析了62例ASA I-III级患者择期LC的医院总费用。获取了每位患者的所有直接和间接可变成本,包括麻醉和手术团队的工资。数据以平均值±标准误表示。
术中麻醉费用占医院总费用的百分比为10.5±0.3%。麻醉后护理单元(PACU)费用为3.1±0.2%。最大的医院费用类别是手术室,占37.4±0.6%。病房费用为31.3±3%。其他费用由放射科(6.2±1.1%)、实验室(5.4±0.7%)、入院单元(3.4±0.2%)、药房(2.0±0.4%)和行政管理(0.7±0.1%)产生。
即使将工资计算在内,麻醉和PACU费用(13.6%)也仅占医院总费用的一小部分。因此,成本节约可能源于提高手术室效率和缩短住院时间,而不是旨在降低麻醉费用的方案。