Poor Cost Awareness Among Anesthesia Providers for Medications, Supplies, and Blood Products

ABSTRACT Background: The objective of this study is to determine if anesthesia providers can accurately estimate the cost of commonly used medications, supplies, and blood products. Methods: This study was conducted between April-June 2019 at an academic tertiary care hospital. Anesthesia providers (certified registered nurse anesthetists [CRNAs], residents, and fellows/attendings) were surveyed on their knowledge of the cost of commonly used therapies. Items were sorted into 12 categories: opioids, non-opioid analgesics, vasopressors, hypertension medications, antibiotics, neuromuscular blockers, reversals, anesthetics, supplies, kits, blood, and blood-related products. Estimates were considered to be accurate if the median cost differed from the average wholesale price by 50%. Results: 107 surveys (CRNAs: 25, Residents: 36, Fellows/Attendings: 46) were returned. The percentage of total items accurately estimated for cost was low (22% for all providers), and was not different between provider types (27% for CRNAs, 23% for residents, and 20% for fellows/attendings) (P=0.69). The percentage of items with severe inaccuracies in cost estimation was high, and was not different between provider types (56% for CRNAs, 60% for residents, and 50% for fellows/attendings) (P=0.53). Rates of under- and overestimation varied widely, with greatest underestimation for vasopressors and blood-related products, and greatest overestimation for non-opioid analgesics and antibiotics. Low and high cost category items tended to be overestimated and underestimated, respectively (P Conclusion: The majority of anesthesia providers have poor knowledge of cost. These findings suggest that cost awareness interventions may be necessary for promoting high-value health care.