ANESTHESIA DRUG COST, CONTROL AND UTILIZATION IN CANADA

Purpose: To investigate the attitudes of senior anaesthetists toward i ssues of anaesthesia drug cost control, utilization, and education, an d to determine patterns of drug use of common clinical scenarios. Meth ods: A questionnaire mailed to heads of anaesthesia departments in all large (>200 beds) Canadian hospitals (n = 187). Data were analyzed wi th chi-square and t tests; P < 0.05 was considered significant. Result s: Sixty-eight per cent responded to the questionnaire. Ninety-four pe r cent considered cost when choosing anaesthetic agents, 63.7% indicat ed cheaper drugs could be used without decreasing quality of care, and 46.3% that restricted access to expensive agents was justified. Only 32.8% of hospitals currently imposed restrictions. Departmental practi ce guidelines were favoured by 82.1% of respondents. Fifty-three per c ent considered resident education about drug cost to be inadequate and 57.4% indicated that resident teaching justified the use of expensive agents. Most respondents (69.8-96.8%) felt they knew the cost of comm only used agents, many made considerable use of cheaper agents such as halothane, curare and morphine, and 61% re-used syringes containing r esidual drug. A few differences between teaching and non-teaching hosp itals anaesthetists were identified. These anaesthetists demonstrated awareness of pharmacoeconomic issues, believed that cheaper anaestheti c agents could be used without compromising quality of care, identifie d Sew hospitals with policies that restricted drug use, and indicated drug cost education could be improved. Control and responsibility of d rug utilization were shared within their hospitals. Many approved the idea of practice guidelines. In common clinical scenarios cheaper agen ts were preferred and syringe re-use was surprisingly common.