Changing Patterns in Volatile Anaesthetic Agent Consumption over Seven Years in Victorian Public Hospitals. Issue 5 (September 2014)

• Record Type: Journal Article
• Authors: Weinberg, L.; Tay, S.; Aykanat, V.; Segal, R.; Tan, C. O.; Peyton, P.; Mcnicol, L.; Story, D. A.
• Is Part Of: Anaesthesia and intensive care. Volume 42:Issue 5(2014)
• Page Start: 579
• Page End: 583
• Publication Date: 2014-09
• Subjects: anaesthetics -- inhalation -- cost control -- attention -- health expenditures; Anesthesiology -- Periodicals; Intensive Care Units -- Periodicals; 617.96
• DOI: 10.1177/0310057X1404200506
• Languages: English
• ISSNs: 0310-057X

Abstract

Evidence-based choices of volatile agents can increase health cost efficiencies. In this pharmaco-economic study, we evaluated the trends and costs of volatile agent use in Australian public hospitals. The total number of volatile agent (isoflurane, sevoflurane and desflurane) bottles ordered and inflation-adjusted costs were collected from 65 Victorian public hospitals from 2005 to 2011. Environmental costs were measured through the 100-year global warming potential index as carbon dioxide equivalents. During this time period, the aggregate inflation-adjusted expenditure was $39, 209, 878. Time series analysis showed that bottles of isoflurane ordered decreased by 419/year (99% confidence interval [CI] −603 to −235); costs decreased by $56, 017/year (99% CI -$93, 243 to -$18, 791). Bottles of sevoflurane increased by 1, 330/year (99% CI 1141 to 1519); costs decreased by $423, 3573/year (99% CI -$720, 030 to -$112, 783). Bottles of desflurane increased by 726/year (99% CI 288 to 1, 164); costs increased by $171, 578/year (99% CI $136, 951 to $206, 205). The amount of calculated greenhouse gas emissions released into the atmosphere over this period was 37, 000 tonnes of carbon dioxide equivalents, with isoflurane contributing 6%, sevoflurane 17%, and desflurane 77% of this total. In conclusion, isoflurane is no longer being used in the majority of Victorian public hospitals, with sevoflurane and desflurane remaining as the primary volatile agents, utilised respectively at a ratio of 2.2 to 1, and costs at 0.8 to 1.