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Aim To assess the equipment costs involved in providing an endoscopy service at a district general hospital. Method Data relating to the purchase price, the number and cost of maintenances and usage over the life of nineteen endoscopes (gastroscopes 12, colonoscopes 7) was collected from medical electronics records. The data was analysed using SPSS 7.5 to determine whether any causal relationships existed. Results The total number of endoscopies carried out by the fibreoptic endoscopes over a fifteen-year period amounted to 23,899 (15,534 [65%] using gastroscopes and 8,365 [35%] using colonoscopes).There were 162 maintenance episodes, an average of 8.5 per endoscope and just over 1 per endoscope/year (range 0.1-0.9). Of the tatal episodes, 92 (57%) were on gastroscopes and the rest 70 (43%) on colonoscopes. The average cost of each maintenance episode amounted to £715, (gastroscope £801, colonoscope £598). There was no correlation between the number of episodes and the total cost of maintenance per endoscope. The average maintenance cost per endoscope amounted to £4.85 (1.43-10.07), (gastroscope £4.85, colonoscope £4.66). When the purchase price was included the average cost per endoscopic procedure amounted to £22.03 (7.20-89.20) (gastroscope £18.81, colonoscope £27.57). This range is highly skewed because of the differential in prices of endoscopes purchased pre and during 1995. Four of the nineteen endoscopes (gastroscopes 2, colonoscopes 2) were purchased during 1995 and cost an average £19,625 compared to the other fifteen endoscopes purchased pre 1995 and cost an average £11,785. The average maintenance cost for the newer endoscopes was £6.42 per endoscope compared to £7.10 for the older endoscopes. The average cost per endoscopic procedure for the newer endoscopes was £51 compared to £19.52 for the older endoscopes. This difference in cost per endoscopic procedure can be attributed to the length of time over which the purchase price depreciates. Conclusion We have projected the average costs of procedure and maintenance of gastroscopes and colonoscopes. There was no significant correlation between the usage and maintenance costs over a fifteen-year period.Within this time period there is no evidence that endoscopes move to being beyond economic repair. |
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