We performed a randomized, prospective study to evaluate the use of a written feedback system in reducing the intraoperative costs of drugs and supplies used by anesthesiologists.
Over 6 mo, 27 anesthesiology residents were randomized to feedback and control groups for their rotations in neurosurgical anesthesia.
We recorded the cost of drugs and supplies for three procedures : carotid endarterectomy, lumbar decompression, and cervical decompression.
For each study case, members of the feedback group received a written cost analysis showing their performance relative to the departmental average.
Members of the feedback group had significantly lower costs for carotid endarterectomies ($79.98 ± $15.20 vs $97.59 ± $21.53) and for lumbar decompressions ($56.72 ± $16.49 vs 576.05 ± $20.11).
The source of savings included lower use rates for propofol and etomidate and for patient warming devices.
Analysis of data from recovery areas revealed a trend toward lower patient temperature in lumbar procedures performed by the feedback group.
Three months after the feedback period, we collected a follow-up data set in the absence of feedback.
This revealed a significant rebound in overall cost by the feedback group for both carotid endarterectomies and lumbar surgery.
Implications : This is the first randomized, prospective evaluation of a cost management system in anesthesia. (...)
Mots-clés Pascal : Anesthésique, Coût, Economie santé, Anesthésie, Etats Unis, Amérique du Nord, Amérique, Pratique professionnelle, Rétroaction
Mots-clés Pascal anglais : Anesthetic, Costs, Health economy, Anesthesia, United States, North America, America, Professional practice, Feedback regulation
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0168455
Code Inist : 002B02B08. Création : 21/07/1998.