Patient‐controlled sedation with propofol for endoscopic procedures—A cost analysis
| Autor: | Lena Nilsson, Folke Sjöberg, Andreas Nilsson, Lars Bernfort, Benjamin Grossmann |
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| Rok vydání: | 2019 |
| Předmět: |
Male
bronchoscopy Sedation 03 medical and health sciences Indirect costs 0302 clinical medicine Bronchoscopy cost analysis medicine Humans Hypnotics and Sedatives Prospective Studies 030212 general & internal medicine endoscopy Letters to the Editor Letter to the Editor health care economics and organizations Aged Nurse Anesthetists Cholangiopancreatography Endoscopic Retrograde Endoscopic retrograde cholangiopancreatography propofol medicine.diagnostic_test business.industry 030208 emergency & critical care medicine General Medicine patient‐controlled sedation surgical procedures operative Anesthesiology and Pain Medicine Anesthesia Costs and Cost Analysis Cost analysis Midazolam Female Premedication medicine.symptom business Propofol medicine.drug |
| Zdroj: | Acta Anaesthesiologica Scandinavica |
| ISSN: | 1399-6576 0001-5172 |
| DOI: | 10.1111/aas.13463 |
| Popis: | Background Patient-controlled sedation (PCS) with propofol accompanied by a bedside nurse anaesthetist is an alternative sedation method for endoscopic procedures compared with midazolam administered by a nurse or endoscopist. Increasing costs in health care demands an economic perspective when introducing alternative methods. We applied a hospital perspective on a cost analysis comparing different methods of sedation and the resource use that were expected to affect cost differences related to the sedation. Methods Based on two randomised previous studies, the direct costs were determined for different sedation methods during two advanced endoscopic procedures: endoscopic retrograde cholangiopancreatography (ERCP) and flexible bronchoscopy including endobronchial ultrasound. ERCP comparisons were made between midazolam sedation by the endoscopic team, PCS with a bedside nurse anaesthetist and propofol sedation administered by a nurse anaesthetist. Bronchoscopy comparisons were made between midazolam sedation by the endoscopic team and PCS with a bedside nurse anaesthetist, categorised by premedication morphine-scopolamine or glycopyrronium. Results Propofol PCS with a bedside nurse anaesthetist resulted in lower costs per patient for sedation for both ERCP (233 USD) and bronchoscopy (premedication morphine-scopolamine 267 USD, premedication glycopyrronium 269 USD) compared with midazolam (ERCP 425 USD, bronchoscopy 337 USD). Aborted procedures that needed to be repeated and prolonged hospital stays significantly increased the cost for the midazolam groups. Conclusion Propofol PCS with a bedside nurse anaesthetist reduces the direct sedation costs for ERCP and bronchoscopy procedures compared with midazolam sedation. |
| Databáze: | OpenAIRE |
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