Riassunto
Nel lontano 1977, quando l’evoluzione tecnologica nell’ambito anestesiologico era ancora agli albori, veniva universalmente riconosciuto che le risorse disponibili per soddisfare la domanda di assistenza sanitaria erano limitate. Nel 1994 Karl e Biher, in un trattato sul contenimento dei costi in sala operatoria, sottolineavano che la sopravvivenza di una specialità come quella dell’anestesia era legata indissolubilmente alla consapevolezza della spesa sanitaria e alla necessità di sviluppare metodi per controllare e ridurre i costi [1]. Al giorno d’oggi è ormai noto che l’universo della sala operatoria è considerato come una delle principali voci di consumo delle risorse mediche ospedaliere. Partendo da questo presupposto è necessario riconoscere che una gestione efficiente della sala operatoria può ridurre i costi e, allo stesso tempo, ottimizzare la gestione del paziente, contribuendo ad aumentare l’efficienza dell’ospedale e la sicurezza per il paziente, anche se a costo di uno sforzo straordinario e di una continua formazione teorico-pratica del personale.
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Bibliografia
Vinodkumar MV, Rebecca J (2004) Cost minimization in anesthesia. Indian J Anest 48:303–306
Fasiolo S, Soiat M, Ditri L, Gullo A (1998) Linee guida generali dell’organizzazione dell’attività anestesiologica nel periodo perioperatorio. ESM, Padova, pp 99–105
Greenberg CP, Brown AR (1997) Cost containment-utilization of techniques, personnel equipement and supplies. In: White PF (ed) Ambulatory anaesthesia and surgery. WB Saunders, Philadelphia, pp 635–647
Orkin FK (1993) Moving toward value-based anesthesia care. J Clin Anesth 5:91–98
Naylor CD (1998) What is appropriate care? N Engl J Med 338:1918–1920
Fisher ES, Wennberg DE, Stukel TA et al (2003) The implications of regional variations in Medicare spending. Part 1: The content, quality, and accessibility of care. Ann Intern Med 138:273–287
Fisher ES, Wennberg DE, Stukel TA et al (2003) The implications of regional variations in Medicare spending. Part 2: Health outcomes and satisfaction with care. Ann Intern Med 138:288–298
Orkin FK (1989) Practice standards: the Midas touch or the emperor’s new clothes? Anesthesiology 70:567–571
Reinhardt U (1991) Health Care Quality Management for the 21st Century. American College of Physician Executives, Tampa
Office of Technology Assessment, US Congress (1982) Strategies for Medical Technology Assessment. 3rd ed. Government Printing Office, Washington
Orkin FK (1999) Outcomes research in anesthesia. Adv Anesthes 16:99–128
Macario A, Vitez TS, Mc Donald T (1995) Where are the costs in peri operative care? Anest 83:1138–1142
Orkin FK (1995) Meaningful cost reduction. Anest 83:1135–1137
Weinstein MC, Stason WB (1977) Foundations of cost effectiveness analysis for health and medical practices. N Eng J Med 296:716–722
Macario A (2010) What does un minute of operating room time cost? J Clin Anest 2:237–240
Dati disponibili nel sito www.akrongeneral.org/portal/page?_pageid=153,10351153&_dad
White PF, Whatcha MF (1993) Are new drugs cost effective for patients undergoing ambulatory surgery? Anest 78:2–5
Glenn DM, Macario A (1999) Management of the operating room: a new practice opportunity for anesthesiologists. Anest Clin Of North Am 17:2
Rutter TW, Brown ACD (1994) Contemporary operating room management. In: Lake CL (ed) Advantages in Anesthesia. Vol 11. Mosby, St Louis, pp 173–214
Horngren CT, Foster G (1991) Cost accounting a managerial emphasis. 6th edn. Prentice Hall, Englewood Cliffs
Johnstone ER, Martinec CL (1993) Costs of anesthesia. Anesth Analg 76:840–848
Eisemberg JM (1989) Clinical economics: a guide to the economic analysis of clinical practises. JAMA 262:2879–2886
Johnstone RE, Jozefczyk KG (1994) Costs of anesthetic drugs: experiences with a cost educational trial. Anesth Analg 78:766–771
Greco PJ, Eisemberg JM (1993) Changing physician’s practises. N Engl J Med 329:1271–1274
Golembiewsky J (2010) Economic considerations in the use of invale anesthetic agents. Am J Health Syst Pharm 67:S9–S12
Agoliati A, Dexter F, Jason L et al (2010) Meta-analysis of average and variability of time to extubation comparing isoflurane with desflurane or isoflurane with sevoflurane. Anesth Analg 110:1443–1439
Weinberg L, Story D, Nam J, McNicol L (2010) Pharmacoeconomics of volatile inhalational anaesthetic agents: an 11 year retrospective analysis. Anaesth Intensive Care 38:849–854
Kennedy RR, French RA (2008) Changing patterns in anesthetic fresh gas flow rates over 5 years in a teaching hospital. Anesth Analg 106:1487–1490.
Kapur PA (1994) Pharmacy acquisition costs: responsible choice versus overutilization of costly pharmaceuticals. Anesth Analg 78:617–618
Becker KE, Carrithers J (1994) Practical methods of cost containment in anestesia and surgery. J Clin Anesth 6:388–399
Wetchler BV (1992) Economic impact of anestesia decision making: they pay the money, we make the choice. J Clin Anesth 4:20S–4S.
Moote CA (1994) The prevention of postoperative pain. Can J Anesth 41:527–533
Durfee DD (1995) A practical approach to achieving a $950,000 cost savings from a joint anesthesia-pharmacy program. Hosp Pharm 30:957–958, 961-963
Gora-Harper ML, Hessel E 2nd, Shadick D (1995) Effect of prescribing guidelines on the use of neuromuscular blocking agents. Am J Health Syst Pharm 52:1900–1904
Horrow JC, Rosenberg H (1994) Price stickers do not alter drug usage. Can J Anaesth 41:1047–1052
ISTAT. Indice dei prezzi per le rivalutazioni monetarie. Periodo di riferimento: agosto 2009. Coefficienti mensili. Aggiornato il 16 settembre 2009
Naguib M, Kopman AF, Ensor JE (2007) Neuromuscular monitoring and postoperative residual curarisation: a metaanalysis. Br J Anaesth 98: 302–316
Gfk strategic marketing. US Healthcare Companies LP, 23 aprile 2007
Gillerman RG, Browning RA (2000) Drug use inefficiency: a hidden source of wasted health care dollars. Anesth Analg 91:921
Miller RD (1989) How should residual neuromuscular blockade be detected? Anesthesiology 70:379–380
Gillerman RG, Browing RA (2000) Drug use inefficiency: a hidden source of wasted health care dollars. Anesth Analg 91:921–924
Ballantyne JC, Chang Y (1997) The impact of choice of muscle relaxant on postoperative recovery time: a retrospective study. Anesth Analg 85:476–482
Lubarsky DA, Glass PS, Ginsberg B et al (1997) The successful implementation of pharmaceutical pratice guidelines. Analysis of associated outcomes and cost savings. SWiPE Group. Systematic Withdrawal of Perioperative Expenses. Anesthesiology 86:1145–1160
Butterworth J, James R, Prielipp RC et al (1998) Do shorter-acting neuromuscolar blocking drugs or opioids associate with reduced intensive care unit or hospital lengths of stay after coronary artery bypass grafting? CABG Clinical Benchmarking Data Base Participants. Anesthesiology 88:1437–1446
Puura AI, Rorarius MG, Manninen P et al (1999) The costs of intense neuromuscolar block for anesthesia during endolaryngeal procedures due to waiting time. Anesth Analg 88:1335–1339
Rinehard EK, Sivarajan M (2012) Costs and wastes in anesthesia care. Curr Opin Anesth 25:221–225
Visser K, Hassink E, Bonsel GJ et al (2001) Randomized controlled trial of total intravenous anesthesia with propofol versus inhalation anesthesia with isoflurane-nitrous oxide. Postoperative nausea and vomiting and economic analysi. Anesthesiology 95:616–626
Smith I (2003) Total intravenous anaesthesia. Is it worth the cost? CNS Drugs 17:609–619
Tremper KK (2010) Who are you going to fire? Anesth Analg 110:278–279
Sharma S, Sidawi J, Ramin S et al (1997) A randomized trial of epidural vs patient-controlled meperidine analgesia during labor. Anesth 87:472–476
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Beretta, L., Mattioli, L., Pasin, L. (2012). Costi dell’anestesia. In: Gullo, A., Murabito, P. (eds) Governo clinico e medicina perioperatoria. Springer, Milano. https://doi.org/10.1007/978-88-470-2793-0_19
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