Koffer H, Hildebrand J R, Connell M L
Clinical Affairs, Philadelphia Association for Clinical Trials, PA 19087.
Am J Hosp Pharm. 1990 May;47(5):1084-8.
The personnel costs associated with handling injectable morphine and meperidine in five hospitals were determined, and the potential savings from using a non-controlled analgesic as an alternative were estimated. Five distinctly different U.S. hospitals were selected for study. Tasks involved in the acquisition, distribution, and preparation of injectable doses of morphine and meperidine were identified, and data on the personnel time required to complete each task were collected. Personnel costs were calculated on the basis of per minute wage rates, and costs that could be avoided if injectable morphine and meperidine were replaced by a nonnarcotic analgesic were estimated by determining the relevance of each task to the use of a noncontrolled injectable agent. The total personnel cost of controlling morphine and meperidine ranged from $0.55 to $0.93 per dose; the weighted average cost was $0.64 per dose. The savings that could be realized by replacing injectable morphine and meperidine with a noncontrolled injectable analgesic ranged from $0.13 to $0.36 per dose; the weighted average avoidable cost was $0.23 per dose. Eliminating the need to control these medications might not result in savings in dollar terms but would free health-care workers to perform other tasks. If costs are interpreted in terms of lost opportunities, such savings are real. The use of a nonnarcotic injectable analgesic in place of injectable morphine and meperidine could save approximately $0.23 in personnel costs per dose at the study hospitals.
确定了五家医院处理注射用吗啡和哌替啶的人员成本,并估计了使用非管制镇痛药作为替代品可能节省的费用。选择了五家截然不同的美国医院进行研究。确定了获取、分发和配制注射用吗啡和哌替啶剂量所涉及的任务,并收集了完成每项任务所需的人员时间数据。根据每分钟工资率计算人员成本,并通过确定每项任务与使用非管制注射剂的相关性,估计如果用非麻醉性镇痛药替代注射用吗啡和哌替啶可避免的成本。控制吗啡和哌替啶的总人员成本为每剂0.55美元至0.93美元;加权平均成本为每剂0.64美元。用非管制注射用镇痛药替代注射用吗啡和哌替啶可实现的节省为每剂0.13美元至0.36美元;加权平均可避免成本为每剂0.23美元。消除控制这些药物的需求可能不会在金钱方面节省开支,但会使医护人员有时间去执行其他任务。如果从机会成本的角度来解释成本,那么这种节省是实实在在的。在研究医院,使用非麻醉性注射用镇痛药替代注射用吗啡和哌替啶,每剂可节省约0.23美元的人员成本。