Development of a classification of anesthetic management methods and protocols for calculating financial costs

Background. The costs of anesthetic support represent a significant and essential component in the expense structure of medical services, diagnosis-related groups (DRGs), and high-tech medical care (HMC) that involve anesthesia. Consequently, there is a need to develop a unified methodology for calculating such costs, which ensures transparency and objectivity in the expense structure data. Developing appropriate protocols for each anesthesia method will enable their use in future calculations when updating and forming new medical services, DRG methods, and HMC that incorporate anesthesia.

Objective: to standardize approaches to calculating costs of anesthetic support.

Material and methods. The study was conducted in two stages. In the first stage, a classification (list) of anesthesia methods was developed for use in calculating the financial costs of anesthetic management. In the second stage, the structural and financial detailing of protocols for anesthesia methods was carried out in accordance with the classification. At each stage, the work of specialists from the Center for Healthcare Quality Assessment and Control was validated by external experts, including anesthesiologists and intensivists.

Results. The developed classification of anesthesia methods for calculating financial costs of anesthetic management, validated by external experts, included nine main methods. For each method, protocols were created for the first hour, the second, and each subsequent hour. These protocols facilitated the calculation of direct costs associated with providing anesthetic management, including labor costs for personnel directly involved in the medical service, costs of consumables, pharmaceuticals, depreciation, and indirect costs excluding the payroll of additional staff. The largest share of costs was attributed to consumables (over 50% for each anesthesia method). Additionally, calculations were made for indirect costs necessary to support the overall activities of medical organization.

Conclusion. The developed protocols for each anesthesia method can be applied in future calculations when updating and forming new services and methods for DRGs and HMC that include anesthesia.

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