Isplativost i korisnost zdravstvenih intervencija u sistemu zdravstvene zaštite - ekonomska analiza anesteziološkog rada

Abstract

Introduction. Pharmacoeconomical assessment in anesthesia should include analysis of alternative therapeutic options in the area of total costs and outcomes. The objective of our study was to determine: (1) direct, indirect and total costs of anesthesia in the Clinical Centre of Serbia; (2) which technique and type of anesthesia is most cost-effective, according to the literature, too; and (3) how the patient is satisfied with providing comprehensive medical services in the field of surgery in the Clinical Centre of Serbia. Methods. Retrospectively, in the year 2006, we calculated direct costs of anaesthesia services (wages, anaesthetics, supplies, etc.) at the Centre of anaesthesiology and reanimatology of the Clinical Center of Serbia. The study group included all anaesthetised patients of both sexes. We had to aggregate data documented into the anesthesia department database of the Clinical Center of Serbia. Numerical data were computed and analyzed by means of Microsoft Office Excel 2003 and SPSS for Windows. Results. Personnel costs (income) accounted for 40% of total direct costs. Anaethetics (medicines and supplies) accounted for 31,80%, and other costs for 28.20% of direct costs. Indirect costs included less than 30% of total assets. Lo cal anesthesia is more cost-effective than general anesthesia for the same type of surgery. Low-flow anesthesia is most cost-effective type of general endotracheal anaesthesia. Newer anaesthetics, nevertheless if more expensive, because of their better pharmacokinetic properties are more efficient than standard anesthetics. Surgical patients were satisfied with 73% of all medical services. Conclusion. The above results of our research, compared to other studies, showed that it is possible to reduce the total cost of anesthesia. Potential saving factors are: low-flow anesthesia, local anesthesia, use of modern anaesthetics and ABC cost analysis.