RESUMO
STUDY OBJECTIVE: To determine whether placing price labels on the vial caps of muscle relaxants increases cost consciousness among anesthesiologists. DESIGN: Retrospective study. SETTING: University hospital departments of anesthesia and pharmacy. MEASUREMENTS AND MAIN RESULTS: We placed price labels on the vial caps of all muscle relaxants for a study period of 1 year. At the beginning of the investigation, we informed the anesthesiologists of the study, discussed the prices for different muscle relaxants, and encouraged utilizing less expensive muscle relaxants whenever possible without compromising patient care. The price labels on the vial caps served as visual reminders of the various costs of muscle relaxants during daily practice. We compared the total amount spent on each muscle relaxant during the period from October 1993 to September 1994 with the period from October 1994 to September 1995. The total number of surgical cases from October 1993 to September 1994 and from October 1994 to September 1995 was unchanged and equaled 20,389 and 20,358 cases, respectively. Expenditures for pancuronium increased 104.1%. Total expenditure decreased by 12.5%, with a net savings of $47,111. CONCLUSION: Expenditures for the less costly pancuronium increased while expenditures for vecuronium and atracurium decreased. Price labeling of muscle relaxants in conjunction with education reduces total pharmacy expenditure on muscle relaxants.
Assuntos
Anestesiologia , Atitude do Pessoal de Saúde , Custos de Medicamentos , Rotulagem de Medicamentos , Fármacos Neuromusculares/economia , Androstanóis/economia , Serviço Hospitalar de Anestesia/economia , Atracúrio/economia , Controle de Custos , Redução de Custos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Capacitação em Serviço , Isoquinolinas/economia , Mivacúrio , Fármacos Neuromusculares Despolarizantes/economia , Fármacos Neuromusculares não Despolarizantes/economia , Pancurônio/economia , Serviço de Farmácia Hospitalar/economia , Estudos Retrospectivos , Rocurônio , Succinilcolina/economia , Tubocurarina/economia , Brometo de Vecurônio/economiaRESUMO
Research reports of child's fears were reviewed from a developmental perspective. These studies suggested that as children's fears change with age they become more complex, varied, and realistic. It was concluded that longitudinal studies of children's fears are needed to support or refute the developmental pattern suggested by these studies of distinct age groups at one point in time. It is also suggested that sex, social class, family relationships, and the media be considered in investigations of the development of children's fears. Implications for practice focused on the use of this information in helping parents deal with fears that concern children as they move through childhood.