Direct cost of pars plana vitrectomy for the treatment of macular hole, epiretinal membrane and vitreomacular traction: a bottom-up approach

Autor: Edward Pringle, Timothy L Jackson, Richard Haynes, EH Hughes, Aris Angelis, Federico Grimaccia, Elena Nicod, Hadi Zambarakji, Panos Kanavos, Marc Costen
Rok vydání: 2015
Předmět:
Pars plana
medicine.medical_specialty
genetic structures
Cost
medicine.medical_treatment
Economics
Econometrics and Finance (miscellaneous)
HC Economic History and Conditions
Vitreomacular traction
Vitrectomy
State Medicine
03 medical and health sciences
0302 clinical medicine
Epiretinal membrane
030225 pediatrics
Ophthalmology
medicine
Humans
I1 Health
Hospital Costs
Activity-based costing
Macular hole
health care economics and organizations
Equipment and Supplies
Hospital
Original Paper
business.industry
Health Policy
I19 Other
Pars plana vitrectomy
Epiretinal Membrane
Health Care Costs
Direct cost
National health service
medicine.disease
Retinal Perforations
Personnel
Hospital
medicine.anatomical_structure
England
RA Public aspects of medicine
030221 ophthalmology & optometry
Optometry
business
Zdroj: The European Journal of Health Economics
Nicod, E, Jackson, T, Grimaccia, F, Angelis, A, Costen, M, Haynes, R, Hughes, E, Pringle, E, Zambarakji, H & Kanavos, P 2015, ' Direct cost of pars plana vitrectomy for the treatment of macular hole, epiretinal membrane and vitreomacular traction : a bottom-up approach ', European Journal of Health Economics, pp. 1-9 . https://doi.org/10.1007/s10198-015-0741-6
ISSN: 1618-7601
DOI: 10.1007/s10198-015-0741-6
Popis: Purpose: The direct cost to the National Health Service (NHS) in England of pars plana vitrectomy (PPV) is unknown since a bottom-up costing exercise has not been undertaken. Healthcare resource group (HRG) costing relies on a top-down approach. We aimed to quantify the direct cost of intermediate complexity PPV. Methods: Five NHS vitreoretinal units prospectively recorded all consumables, equipment and staff salaries during PPV undertaken for vitreomacular traction, epiretinal membrane and macular hole. Out-of-surgery costs between admission and discharge were estimated using a representative accounting method. Results: The average patient time in theatre for 57 PPVs was 72 min. The average in-surgery cost for staff was £297, consumables £619, and equipment £82 (total £997). The average out-of-surgery costs were £260, including nursing and medical staff, other consumables, eye drops and hospitalisation. The total cost was therefore £1634, including 30 % overheads. This cost estimate was an under-estimate because it did not include out-of-theatre consumables or equipment. The average reimbursed HRG tariff was £1701. Conclusions: The cost of undertaking PPV of intermediate complexity is likely to be higher than the reimbursed tariff, except for hospitals with high throughput, where amortisation costs benefit from economies of scale. Although this research was set in England, the methodology may provide a useful template for other countries.
Databáze: OpenAIRE
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