PRACTICAL METHODS OF COST-CONTAINMENT IN ANESTHESIA AND SURGERY

With the increasing focus of national attention on health care and hea lth care costs, anesthesiologists, along with all other medical specia lists, must become more cost conscious in their practice behaviors. Th is review describes the current concerns about health care in the Unit ed States, including a discussion of some of the forces causing the in crease in health care spending. The role of anesthesiology in the incr ease in health care costs is discussed. Practical methods for controll ing anesthesia costs are outlined, including reducing preoperative tes ting, decreasing blood product use, and employing more regional and lo cal anesthetic techniques. Several ideas for reducing the costs of ane sthetic gases and drugs, including low-flow anesthesia and less expens ive alternative drugs, are presented. The final section describes the changes in anesthesia drug use that occurred from 1992 to 1993 at one health care center (St. Francis Regional Medical Center; Wichita, ICS, which is associated with the University of Kansas School of Medicine- Wichita). These changes resulted in a 13% reduction in anesthesia drug costs, which amounted to a savings of $127,472. The largest decreases were in anesthetic gases (16%), resulting from an increase in the use of low-flow techniques, and in muscle relaxants (26%), resulting from a switch to older lower-cost drugs.