Johannes W Steyn1, David M Broussard2, Neil DiGiovanni3, Sheena Babin4, Adrianna C Dornelles5. 1. Cardiothoracic Fellow, Ochsner Health System, Department of Anesthesiology. 2. System Vice Chair, Department of Anesthesiology (East Bank) & Community Pain Operations and Cardiothoracic Anesthesiologist. 3. Staff Anesthesiologist, Ochsner Health System, Department of Anesthesiology. 4. Pharmacist, Ochsner Health System, Department of Anesthesiology. 5. Biostatistician, Center for Health Research Ochsner Clinic Foundation.
Abstract
BACKGROUND: All physicians bear the responsibility of minimizing cost while providing care that meets or exceeds national quality benchmarks. Intraoperative anesthetic drug costs constitute a small but significant fraction of the total cost in the perioperative period. Previous studies have revealed that anesthesiologists are generally unaware of drug costs. In order to determine if experience and education improve anesthetic drug cost containment, we compared the total anesthetic drug cost per case as residents progressed through their rotations in cardiac anesthesia. METHODS: We considered the total anesthetic drug cost for 202 adult cardiac cases, including coronary artery bypass grafting, mitral valve repair/replacement, and aortic valve repair/replacement. 77 of the cases analyzed were done by residents in their first month of cardiac anesthesia, and 125 were done by residents in their second month of cardiac anesthesia. In the interval between these rotations, residents participate in didactics and other educational activities including a practice management rotation in the CA-3 year where they are exposed to financial topics in healthcare. RESULTS: The average total drug cost per case for residents in their first month was $193.50; SD= $82.00. The average total cost per case for residents in their second month was $223.30; SD=$96.10. With multivariate analysis considering case type, length of procedure and patient age, the resident training level did not impact the cost in a significant way (p=0.062). CONCLUSIONS: In the multivariate analysis considering case type, length of procedure and patient age, more experienced residents did not have a significantly different total drug cost per case. This finding suggests that didactic educational efforts and implicit modeling over time did not reduce drug costs in the operating room during adult cardiac surgery.
BACKGROUND: All physicians bear the responsibility of minimizing cost while providing care that meets or exceeds national quality benchmarks. Intraoperative anesthetic drug costs constitute a small but significant fraction of the total cost in the perioperative period. Previous studies have revealed that anesthesiologists are generally unaware of drug costs. In order to determine if experience and education improve anesthetic drug cost containment, we compared the total anesthetic drug cost per case as residents progressed through their rotations in cardiac anesthesia. METHODS: We considered the total anesthetic drug cost for 202 adult cardiac cases, including coronary artery bypass grafting, mitral valve repair/replacement, and aortic valve repair/replacement. 77 of the cases analyzed were done by residents in their first month of cardiac anesthesia, and 125 were done by residents in their second month of cardiac anesthesia. In the interval between these rotations, residents participate in didactics and other educational activities including a practice management rotation in the CA-3 year where they are exposed to financial topics in healthcare. RESULTS: The average total drug cost per case for residents in their first month was $193.50; SD= $82.00. The average total cost per case for residents in their second month was $223.30; SD=$96.10. With multivariate analysis considering case type, length of procedure and patient age, the resident training level did not impact the cost in a significant way (p=0.062). CONCLUSIONS: In the multivariate analysis considering case type, length of procedure and patient age, more experienced residents did not have a significantly different total drug cost per case. This finding suggests that didactic educational efforts and implicit modeling over time did not reduce drug costs in the operating room during adult cardiac surgery.
Authors: Patricia A Cowper; Elizabeth R DeLong; Eric D Peterson; Edward L Hannan; Kevin T Ray; Michael Racz; Daniel B Mark Journal: Am Heart J Date: 2002-01 Impact factor: 4.749
Authors: Andrea M Sisko; Christopher J Truffer; Sean P Keehan; John A Poisal; M Kent Clemens; Andrew J Madison Journal: Health Aff (Millwood) Date: 2010-09-09 Impact factor: 6.301
Authors: Matthew R Reynolds; Nancy Neil; Kalon K L Ho; Ronna Berezin; Roberta S Cosgrove; Robert A Lager; Cheryl Sirois; Robert G Johnson; David J Cohen Journal: Am Heart J Date: 2003-02 Impact factor: 4.749