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Titolo:
Cost considerations in the use of anaesthetic drugs
Autore:
Smith, I;
Indirizzi:
N Staffordshire Hosp, Stoke On Trent ST4 6QG, Staffs, England N Staffordshire Hosp Stoke On Trent Staffs England ST4 6QG taffs, England Univ Keele, Keele ST5 5BG, Staffs, England Univ Keele Keele Staffs England ST5 5BG e, Keele ST5 5BG, Staffs, England
Titolo Testata:
PHARMACOECONOMICS
fascicolo: 5, volume: 19, anno: 2001,
parte:, 1
pagine: 469 - 481
SICI:
1170-7690(2001)19:5<469:CCITUO>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
PHARMACEUTICAL PRACTICE GUIDELINES; LOW-FLOW ANESTHESIA; POSTOPERATIVE NAUSEA; SUCCESSFUL IMPLEMENTATION; OUTPATIENT ANESTHESIA; AMBULATORY SURGERY; ANTIEMETIC THERAPY; PROPOFOL; SEVOFLURANE; ISOFLURANE;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
50
Recensione:
Indirizzi per estratti:
Indirizzo: Smith, I N Staffordshire Hosp, Newcastle Rd, Stoke On Trent ST4 6QG, Staffs, England N Staffordshire Hosp Newcastle Rd Stoke On Trent Staffs England ST4 6QG
Citazione:
I. Smith, "Cost considerations in the use of anaesthetic drugs", PHARMACOECO, 19(5), 2001, pp. 469-481

Abstract

Anaesthetic drugs typically comprise approximately 5% or less of a hospital pharmacy budget, yet they are a common target for cost reduction measures. In particular, there is considerable pressure to use less costly productswhere alternatives exist and to limit the introduction of expensive new items. In considering strategies to reduce a departmental drug budget, or in defending against restrictions imposed from outside, it is: important to consider all of the costs associated with anaesthetic drug delivery. These costs comprise not only the expense of the anaesthetic drugs themselves, but alsofixed and variable costs associated with their delivery and related to their effects. Elimination of drug waste will always be beneficial, since it has no direct effect on the patient yet clearly reduces cost. Waste is by nomeans confined to anaesthetic drugs, however. Using less expensive drugs may appear an attractive option and can reduce costs, provided that patient outcome is in no way affected. Rarely is this the case. Once patient care is modified, through changes in recovery times or complication rates, determining the true cost of the intervention becomes essential; there may be increases in indirect costs which dwarf the apparent savings. Sometimes indirect costs will rise by a lesser amount than savings in direct costs, such that there is still an overall benefit but less than thatoriginally anticipated. Exactly how indirect effects result in indirect costs is highly variable. The requirement for additional drugs or supplies totreat an adverse event, such as emesis, will always have an associated cost. Delayed recovery or prolonged hospital stay will waste operating room time or increase the amount of time that a patient requires nursing care, butwhether this carries an associated cost depends on what the staff would otherwise have been doing. Depending on the employment method, staff may havebeen sent home early (with less pay) or employed at identical cost but with less to do. Many studies which purport to consider all costs either ignore such issues, or make invalid assumptions. These issues are complex, but anyone involved with decisions concerning anaesthetic costs should be familiar with the underlying principles and be able to make a rational assessmentof the likely indirect costs in their own institution.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/04/20 alle ore 16:08:07