[A method for the evaluation of resource use in cardiac surgery: application of the ICR beta in an Italian reality].

The decreased availability of economic resources requires the use of methods to assess hospital efficiency. The aim of our study was to retrospectively evaluate the applicability to the Italian reality of a catalogue of medical acts (CdAM-champs beta) set up for the French Health System. We wanted to evaluate the amount of resource utilization of a Cardiothoracic Operating Room of a IRCCS regional general hospital. The study included 83 admissions, occurring in October 1996, to the cardiac surgery department. Medical acts were recorded for all admissions taking into account both the number of acts and the weight of acts expressed as standard cost index or ICR. This takes into account the use of human (medical and nursing staff) and technical resources. Calculation of ICR beta scores was achieved by means of two different expressions. We observed a lack of correlation between the two values of each ICR. The previous formula (1991) gives more emphasis on the different conditions in which the operation was carried out (American Society of Anesthesiology score), duration of anesthesia and patients disease with a statistical significant difference. The last formula (1995) only evaluate patients' disease. None of the two formula of ICR beta turns out to be completely appropriate index of resource utilization during anesthesia; therefore this analysis still remains a difficult problem. Yet it must be recognized that this system deserves the merit of having evaluated the anesthesiological duties, by separating them from the surgical ones.