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法国医院中用于麻醉护理的即用型预填充阿托品注射器 - 预算影响分析。

Ready-to-use pre-filled syringes of atropine for anaesthesia care in French hospitals - a budget impact analysis.

机构信息

AP-HP, CHU de Bicêtre, hôpitaux universitaires Paris Sud, hôpital Bicêtre, service anesthésie-réanimation, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.

Hospices Civils de Lyon Sud, service d'anesthésie-réanimation, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.

出版信息

Anaesth Crit Care Pain Med. 2017 Apr;36(2):115-121. doi: 10.1016/j.accpm.2016.03.009. Epub 2016 Jul 30.

Abstract

BACKGROUND

Patient safety is improved by the use of labelled, ready-to-use, pre-filled syringes (PFS) when compared to conventional methods of syringe preparation (CMP) of the same product from an ampoule. However, the PFS presentation costs more than the CMP presentation.

OBJECTIVE

To estimate the budget impact for French hospitals of switching from atropine in ampoules to atropine PFS for anaesthesia care.

METHODS

A model was constructed to simulate the financial consequences of the use of atropine PFS in operating theatres, taking into account wastage and medication errors. The model tested different scenarios and a sensitivity analysis was performed.

RESULTS

In a reference scenario, the systematic use of atropine PFS rather than atropine CMP yielded a net one-year budget saving of €5,255,304. Medication errors outweighed other cost factors relating to the use of atropine CMP (€9,425,448). Avoidance of wastage in the case of atropine CMP (prepared and unused) was a major source of savings (€1,167,323). Significant savings were made by means of other scenarios examined. The sensitivity analysis suggests that the results obtained are robust and stable for a range of parameter estimates and assumptions.

STUDY LIMITATIONS

The financial model was based on data obtained from the literature and expert opinions.

CONCLUSION

The budget impact analysis shows that even though atropine PFS is more expensive than atropine CMP, its use would lead to significant cost savings. Savings would mainly be due to fewer medication errors and their associated consequences and the absence of wastage when atropine syringes are prepared in advance.

摘要

背景

与从安瓿中制备相同产品的传统注射器准备方法(CMP)相比,使用标签、即用型、预填充注射器(PFS)可提高患者安全性。然而,PFS 的呈现成本高于 CMP 的呈现成本。

目的

估计法国医院从安瓿中的阿托品切换到用于麻醉护理的阿托品 PFS 的预算影响。

方法

构建了一个模型,以模拟在手术室中使用阿托品 PFS 的财务后果,同时考虑了浪费和用药错误。该模型测试了不同的方案并进行了敏感性分析。

结果

在参考方案中,系统地使用阿托品 PFS 而不是阿托品 CMP 可节省一年的净预算 5,255,304 欧元。用药错误超过了与使用阿托品 CMP 相关的其他成本因素(9,425,448 欧元)。避免阿托品 CMP(准备好但未使用)的浪费是节省的主要来源(1,167,323 欧元)。通过检查其他方案,也可以节省大量资金。敏感性分析表明,对于一系列参数估计和假设,所获得的结果是稳健和稳定的。

研究局限性

财务模型基于从文献和专家意见中获得的数据。

结论

预算影响分析表明,即使阿托品 PFS 比阿托品 CMP 更昂贵,但其使用仍将带来显著的成本节约。节省主要归因于用药错误及其相关后果减少,以及在预先准备阿托品注射器时避免浪费。

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