Registration of Anesthesia Time in Surgical Operation and its Costs in the Hospitals of East Azarbayjan

With the introduction of the book Relative Value, anesthesia has increased, and as prolonged anesthesia time, along with the risks and adverse effects, impose a financial burden on the patient and the hospital, it is essential to review the costs required by this department and to monitor the maintenance of the insurance organization's resources and reduce payments from the insured's pockets. The aim of this study was to determine the incidence of unrealistic anesthesia registrations and their impact on costing in East Azerbaijan.

This descriptive study was performed by extracting data from 8 selected hospitals by purposeful stratified method based on criteria and indicators (including 182 surgical records). Descriptive statistics and one-way ANOVA and variance test were used to classify the data.

Most of the surgeries were related to health insurance funds (48%). The average unit of anesthesia time elapsed for each operation was similar in different surgeries in different hospitals. The time taken for global action was longer than the average time recorded for each operation in private hospitals and public hospitals. In clinical records, overlap of anesthesia was extracted according to available documentation based on calculation of duration of each physician's activity and concurrent anesthesia management of two patients by physician during office hours. The average overwriting in public hospitals was 26.6% and in private hospitals 54%. In 19% of the time the anesthesia was started before the patient entered the operating room and in 36% of the cases the end of the anesthesia was recorded after the patient had left the operating room and 43% of the total requested hospital units were surplus. Since P-Value<0.05 was considered statistically significant in this study, the result of claiming a significant difference between the average amount of anesthesia for similar operations in private and public hospitals was rejected (p = 0.793). 

The amount requested for anesthesia times in both public and private hospitals is higher than the actual amount. Therefore, the cost can be controlled by applying the calculation method of unrealistic registration cases. Also, the unit of anesthesia time considered in the Global Time List is higher than the average unit recorded for each operation in the studied hospitals. Therefore, a review of the list of times of global actions seems necessary.