Comparison of costs among anesthesia providers using « cost per case » does not adjust for variations in casemix (such as the type of procedure and patient condition).
The authors propose an alternative method for comparing costs using the American Society of Anesthesiologists'Relative Value Scale (ASARVS) system, which incorporates basic units (for the procedure), modifier units (for the patient's physical condition), « other » units (such as for the placement of invasive monitors), and time units (proportional to the case duration).
Data were obtained from a series of 3,340 anesthetics performed at a tertiary hospitaL Administered and discarded drug, supply, and fluid costs were used.
Costs expressed as dollars per ASARVS unit had 54% less variability than costs expressed as dollars per case (P<0.0001).
Pearson correlations between demographic variables and cost per ASARVS unit ranged from - 0.10 to 0.13.
Total (e.g., quarterly) costs for simulated sets of cases were predicted within 0.0 ± 2.3% by multiplying (1) their sum of units and (2) a like set of case's sum of costs divided by sum of units.
Costs of anesthetic supplies and drugs of a case were more accurately reported as « cost per unit » than as cost per case. (...)
Mots-clés Pascal : Analyse coût, Pratique professionnelle, Anesthésie, Service hospitalier, Contrôle coût, Système information, Méthode statistique, Economie santé, Etats Unis, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Cost analysis, Professional practice, Anesthesia, Hospital ward, Cost control, Information system, Statistical method, Health economy, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0264021
Code Inist : 002B30A04B. Création : 11/09/1998.