Cost Analysis of Anesthesia Services in Selected Christian Health Association of Ghana Hospitals in the Eastern Region of Ghana

Abstract

Background: Anesthesia is essential in modern surgical procedures, ensuring patient comfort and enabling successful operations. However, the financial burden it imposes on patients, including both direct expenses and hidden indirect costs, is not well understood. This lack of awareness may compromise financial protection policy design that should appropriately insulate surgical patients from catastrophic health spending. Furthermore, a clearer understanding of anesthesia-related costs may encourage healthier behaviors, potentially reducing the risk of surgery and the associated financial burdens. Therefore, this study aims to evaluate the economic burden of anesthesia to inform society and policymakers about the appropriate course of action to minimize the risk of surgery and the associated costs. Method: A cross-sectional consecutive design was used, in which 192 surgical patients were sampled prospectively and data collected within four months, spanning January to May 2024, through face-to-face interviews following informed consent and approval by the patients or their carer, whichever was appropriate. Setting was seven Christian Health Association of Ghana (CHAG) hospitals in the Eastern region. Descriptive statistical analysis was performed on participant background data while inferential statistical analysis was used to estimate anesthesia related costs and the determining factors. Cost analysis was stratified by type of anesthesia for precision estimate. Results: The findings indicate that the mean total direct cost for patients who underwent regional anesthesia was GHS202.54 (95% CI: 63.36-341.73), while those receiving general anesthesia incurred GHS81.37 (95% CI: -11.90-174.63). No direct costs were recorded for patients under local anesthesia. Indirect costs, measured as lost productivity, were highest for regional anesthesia (GHS1,128.9 per patient), followed by general anesthesia (GHS924.2) and local anesthesia (GHS527.3). Key factors influencing anesthesia costs included the presence of other surgical conditions (p=0.048), household size of 5-9 members (p=0.011), and marital status (p=0.053), indicating that demographic and social factors play a role in determining financial burden. Conclusion: This study highlights the financial burden of different anesthesia types, with regional anesthesia being the most expensive in both direct and indirect costs. Understanding these expenses can help prospective surgical patients to better prepare financially or avoid these costs by prioritizing health prevention that reduces their risk of surgery and by extension anesthesia. In the quest for Ghana to ensure better financial risk protection, this study emphasized the need to expand National Health Insurance Scheme (NHIS) benefit package to cover anesthesia services.