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THE «MISSION» OF ANAESTHESIA AND RESUSCITATION UNITS  SMART 2001 Freefree

Minerva Anestesiologica 2001 April;67(4):284-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Cost optimisation in anaesthesia

Bauer M., Bach A. *, Martin E. **, Böttiger B. W. **

From the Department of Anaesthesia University of Kiel, Germany *Coordinator for Quality Management **Department of Anaesthesia University of Heidelberg, Germany


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As a ­result of the ­progress ­which has ­been ­made in med­i­cine and tech­nol­o­gy and the ­increase in mor­bid­ity asso­ciat­ed ­this dem­o­graph­ic devel­op­ment, the ­need and ­thus the ­costs for med­i­cal ­care ­have ­increased as ­well. The finan­cial resourc­es ­which are avail­able for med­i­cal ­care, how­ev­er, are ­still lim­it­ed and ­hence the ­funds ­which are avail­able ­must be dis­trib­ut­ed ­more effi­cient­ly. ­Cost optim­isa­tion meas­ures can ­help ­make bet­ter use of the prof­it­abil­ity ­reserves in hos­pi­tals. The ­authors ­show how ­costs can be optim­ised in the anaesthe­sio­lo­gy depart­ment of a clin­ic. Phar­ma­coec­o­nom­ic eval­u­a­tion of the new inha­la­tion anaesthet­ics ­shows an exam­ple of how the ­cost struc­tures in anaesthe­sia can be ­made ­more obvi­ous and poten­tial ­ways sav­ings be imple­ment­ed. To ­reduce mate­ri­al and per­son­nel ­costs, a ­more ration­al ­means of inter­nal pro­cess man­age­ment is pre­sent­ed. Accord­ing to ­cost-effec­tive­ness anal­y­sis, med­i­ca­tions are not divid­ed ­into the cat­e­go­ries inex­pen­sive and expen­sive but rath­er ­cost-effec­tive or non-­cost-effec­tive. By select­ing a ­cost-effec­tive ­drug it is pos­sible to ­reduce ­cost at a hos­pi­tal. For exam­ple, sevof­lu­rane at a ­fresh gas ­flow of ­below 3 l/min has ­been ­shown to be a ­cost-effec­tive inha­la­tion anaesthet­ic ­which, in ­terms of the eco­nom­ics, is ­also super­i­or to intra­ve­nous anaesthe­sia ­with pro­pof­ol. In addi­tion to ­these meas­ures of reduc­ing mate­ri­al ­costs, oth­er exam­ples are giv­en of how per­son­nel ­costs can be ­reduced by optim­is­ing ­work pro­ce­dures: e.g. effec­tive oper­at­ing thea­tre co-ordi­na­tion, ­short switch­over ­times by over­lap­ping anaesthe­sia induc­tion and the use of mul­ti­func­tion­al per­son­nel. The ­gain in pro­duc­tiv­ity ­which is a ­result of ­these meas­ures can pos­i­tive­ly ­affect prof­its, and by optim­is­ing the organ­isa­tion of pro­ce­dures to short­en the ­times ­required to car­ry out a pro­ce­dure, ­costs can be ­reduced.

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