Effect of different cost drivers on cost per anesthesia minute in different anesthesia subspecialties.
BACKGROUND
Little is known about differences in costs to provide anesthesia care for different surgical subspecialties and which factors influence the subspecialty-specific costs.


METHODS
In this retrospective study, the authors determined main cost components (preoperative visit, intraoperative personnel costs, material and pharmaceutical costs, and others) for 10,843 consecutive anesthesia cases from a 6-month period in the 10 largest anesthesia subspecialties in their university hospital: ophthalmology; general surgery; obstetrics and gynecology; ear, nose, and throat surgery; oral and facial surgery; neurosurgery; orthopedics; cardiovascular surgery; traumatology; and urology. Using regression analysis, the effect of five presumed cost drivers (anesthesia duration, emergency status, American Society of Anesthesiologists physical status of III or higher, patient age younger 6 yr, and placement of invasive monitoring) on subspecialty-specific costs per anesthesia minute were analyzed.


RESULTS
Both personnel costs for anesthesiologists and total costs calculated per anesthesia minute were inversely correlated with the duration of anesthesia (adjusted R2 = 0.75 and 0.69, respectively), i.e., they were higher for subspecialties with short cases and lower for subspecialties with longer cases. The multiple regression model showed that differences in anesthesia duration alone accounted for the majority of the cost differences, whereas the other presumed cost drivers added only little to explain subspecialty-specific cost differences.


CONCLUSIONS
Different anesthesia subspecialties show significant and financially important differences regarding their specific costs. Personnel costs and total costs are highest for subspecialties with the shortest cases. Other analyzed cost drivers had little effect on subspecialty-specific costs. In the light of these cost differences, a detailed cost analysis seems necessary before the profitability of an anesthesia subspecialty can be assessed.
Schuster
Martin
M
Department of Anesthesiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. m.shuster@uke.uni-hamburg.de
Standl
Thomas
T
Wagner
Joachim A
JA
Berger
Jürgen
J
Reimann
Hajo
H
Am Esch
Jochen Schulte
JS
D000328:Adult; D000367:Age Factors; D000758:Anesthesia / Q000191:economics*; D000776:Anesthesiology; D000777:Anesthetics / Q000191:economics; D002405:Catheterization, Central Venous / Q000191:economics; D002648:Child; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D016527:Drug Costs; D004471:Economics, Nursing; D004632:Emergency Medical Services / Q000191:economics; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative / Q000191:economics; D009873:Operating Rooms / Q000191:economics; D010564:Personnel, Hospital / Q000191:economics; D012044:Regression Analysis; D012189:Retrospective Studies; D013038:Specialization; D013997:Time Factors; D000078329:Workforce
D000777:Anesthetics