Cost management of general and regional anaesthesia techniques in context of quality resource management at the department of orthopaedics

Background and Purpose: In this study the goal was to analyze costs of regional versus general anaesthesia techniques through a retrospective study. Using an interdisciplinary approach of cost management in health care institutions, independent financial analysis of costs of surgical procedures and resource utilization was conducted. The study has several aims: to emphasize benefits of regional compared to general anaesthesia, and emphasize the need for better resource allocation in order to stay competitive. Both of the aims can be summarized into one main goal, interdisciplinary approach in health care institutions must be recognized in order to organize quality (cost) management of the institution. Materials and Methods: 181 patient’s medical records were analyzed during different surgical procedures performed under regional or general anaesthesia. Data such as duration of operation and anaesthesia, total costs of physician and material used during the procedure, as well as anaesthesia technique were extracted from the records and elaborated. Results: Ratio of regional to general anaesthesia was 61%:39% in the observed 4 month period. Average total cost of regional anaesthesia operation, calculated from the surgical lists for the observed four month period, was 11,6 , while average total cost of general anaesthesia was 44, 8 . Thereby costs of anaesthesia technique were lower (p<0,01) for regional anaesthesia. Both material and medication costs showed statistically and clinically relevant difference, since they were significantly less in regional anaesthesia group (p<0,01). Conclusion: Study showed clear economic benefits of regional anaesthesia compared with general anaesthesia. It was concluded that regional anaesthesia indeed does have lower costs than general anaesthesia. Great discrepancy between physicians’ salary and the salary they actually earn by spending specific amount of time working in the OR suggest poor resource utilization.