Rigante Luigi, Moudrous Walid, de Vries Joost, Grotenhuis André J, Boogaarts Hieronymus D
Neurosurgery Department, Radboud University Medical Center, Geert Grooteplein 8, Nijmegen, 6525, GA, The Netherlands.
Acta Neurochir (Wien). 2017 Dec;159(12):2337-2340. doi: 10.1007/s00701-017-3366-y. Epub 2017 Oct 25.
Operating rooms account for 70% of hospital waste, increasing healthcare costs and creating environmental hazards. Endovascular treatment of cerebrovascular pathologies has become prominent, and associated products highly impact the total cost of care. We investigated the costs of endovascular surgical waste at our institution.
Data from 53 consecutive endovascular procedures at the Radboud UMC Nijmegen from May to December 2016 were collected. "Unused disposable supply" was defined as one-time use items opened but not used during the procedure. Two observers cataloged the unused disposable supply for each case. The cost of each item was determined from the center supply catalog, and these costs were summed to determine the total cost of unused supply per case.
Thirteen diagnostic cerebral digital subtraction angiographies (DSA) (24.5%) and 40 endovascular procedures (75.5%) were analyzed. Total interventional waste was 27,299.53 € (mean 515.09 € per procedure). While total costs of unused disposable supply were almost irrelevant for DSAs, they were consistent for interventional procedures (mean 676.49 € per case). Aneurysm standard coiling had the highest impact on total interventional waste (mean 1061.55 €). Disposable interventional products had a very high impact on the surgical waste costs in the series of the neurointerventional procedures (95% of total waste).
This study shows the impact of neurointerventional waste on the total care costs for cerebrovascular patients. This might reflect the tendency to anticipate needs and emergencies in neurointervention. Responsible use of disposable material can be achieved by educating operators and nurses and creating operator preference cards.
手术室产生的废物占医院废物的70%,这增加了医疗成本并造成环境危害。脑血管疾病的血管内治疗已变得突出,相关产品对护理总成本有很大影响。我们调查了我们机构血管内手术废物的成本。
收集了2016年5月至12月在奈梅亨拉德堡大学医学中心连续进行的53例血管内手术的数据。“未使用的一次性耗材”定义为在手术过程中打开但未使用的一次性用品。两名观察员对每个病例的未使用一次性耗材进行了分类。每件物品的成本从中心耗材目录中确定,并将这些成本相加,以确定每个病例未使用耗材的总成本。
分析了13例诊断性脑数字减影血管造影(DSA)(24.5%)和40例血管内手术(75.5%)。总介入废物为27299.53欧元(平均每次手术515.09欧元)。虽然未使用一次性耗材的总成本对DSA几乎无关紧要,但在介入手术中却较为一致(平均每个病例676.49欧元)。动脉瘤标准弹簧圈栓塞对总介入废物的影响最大(平均1061.55欧元)。一次性介入产品对神经介入手术系列中的手术废物成本影响非常大(占总废物的95%)。
本研究显示了神经介入废物对脑血管疾病患者护理总成本的影响。这可能反映了神经介入中对需求和紧急情况进行预判的趋势。通过对操作人员和护士进行培训并创建操作人员偏好卡,可以实现对一次性材料的合理使用。