title: Effect of different cost drivers on cost per anesthesia minute in different anesthesia subspecialties.
abstract: 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.
authors.affiliation: Department of Anesthesiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. m.shuster@uke.uni-hamburg.de
authors.forename: Martin
authors.initials: M
authors.lastname: Schuster
authors.forename: Thomas
authors.initials: T
authors.lastname: Standl
authors.forename: Joachim A
authors.initials: JA
authors.lastname: Wagner
authors.forename: Jürgen
authors.initials: J
authors.lastname: Berger
authors.forename: Hajo
authors.initials: H
authors.lastname: Reimann
authors.forename: Jochen Schulte
authors.initials: JS
authors.lastname: Am Esch
mesh_terms: 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
chemical_list: D000777:Anesthetics