[剖宫产的蛛网膜下腔麻醉与全身麻醉的成本比较]。

Anestezjologia intensywna terapia Pub Date : 2010-07-01
Magdalena Kwiatosz-Muc, Leszek Wdowiak, Andrzej Nestorowicz, Michał Kowalczyk
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引用次数: 0

摘要

背景:现代医学越来越意识到经济组织方面。在麻醉学领域,由于药理学的不断进步,使用的药物数量显著增加。其中很大一部分是昂贵的。本研究的目的是比较剖宫产的一般麻醉和蛛网膜下腔麻醉的住院费用。方法:从服务提供者的角度评估成本。根据麻醉过程中使用的资源的详细数据,采用微成本法测量直接成本。非医疗费用采用直接分配法(辅助单位费用)计算。单位住院费用采用“自上而下”评估确定。麻醉人员工作相关费用采用基于麻醉时间的微成本法计算。进行敏感性分析。结果:剖宫产术中全身麻醉的平均直接费用低于蛛网膜下腔麻醉。与全身麻醉相比,蛛网膜下腔麻醉的平均人员成本较高。全身麻醉的药物费用低于蛛网膜下腔麻醉。与所用方法相关的医疗材料成本在蛛网膜下腔麻醉中明显较高。结论:蛛网膜下腔麻醉较普通麻醉耗时长,医务人员工作成本高。与蛛网膜下腔麻醉相比,避免吸入麻醉剂(七氟醚)使全身麻醉的间接成本更低。
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[Costs of subarachnoid vs. general anaesthesia for caesarean section].

Background: Modern medicine is becoming increasingly aware of economic-organizational aspects. In the field of anaesthesiology, the number of agents used markedly increases due to continuous pharmacological progress. A high proportion of them are expensive. The aim of the study was to compare hospital costs of general vs. subarachnoid anaesthesia for Caesarean section.

Methods: Costs were assessed from the perspective of a service provider. Direct costs were measured using the micro-cost method based on detailed data of the resources used during anaesthetic procedures. Non-medical costs were calculated by the direct allocation method (costs of auxiliary units). Unit costs of hospitalization were determined using the "top-to-bottom" assessment. Costs related to anaesthetic staff work were calculated by the micro-cost method based on duration of anaesthesia. Sensitivity analysis was performed.

Results: Mean direct cost of general anaesthesia for Caesarean section was lower than of subarachnoid anaesthesia. Mean personnel cost of subarachnoid anaesthesia was found to be higher compared to general anaesthesia. Costs of pharmaceuticals for general anaesthesia were lower than for subarachnoid one. Costs of medical materials related to the method used were significantly higher in subarachnoid anaesthesia.

Conclusions: Subarachnoid anaesthesia takes more time than general one, which results in higher costs of medical staff work. Avoiding inhalation anaesthetics (sevoflurane) makes indirect costs of general anaesthesia lower compared to subarachnoid anaesthesia.

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