Reductions in anesthesia direct costs is not the right way for racionalization of anesthesia costs

Anesthesia management is characterized by salary limiting and pressure for decreasing anesthetics and other drug budget. The aim of this paper is to determine the possibility of reducing the direct costs in anesthesia. This paper is a part ofa five-year (2005-2009), academic, pharmaco-economic retrospective- prospective study (phase IV). The study was done according to European Union Directive for Clinical Research. We retrospectively calculated and analyzed all anesthesia direct costs (personnel costs, anesthetics and other drug costs, materials, laboratory analyses, and machines) at the Institute For Ane- sthesia and Reanimation, Clinical Center of Serbia in relation to the costs refunded by National Health Insurance in all patients who underwent anesthesia in 2006. Out of 70 195 anesthesia services rendered to 32 267 patients in one-year period, 47% were general anesthesia, 23% were local anesthesia, and 30% were anesthetic procedures. Our results of highly significant association between personnel costs (r = 0.980, p = 0.000) and consumption of anesthetics and drugs (r = 0.885, p = 0.000) with the direct costs do not provide an opportunity for further cost reduction due to disassociation of direct costs and the "unit price" of National Health Insurance issued in terms of the restricted maximum budget for health. There is no space for direct cost reduction in anesthesia.