Farber Nicholas J, Chuchvara Nadiya, Modi Parth K, Sterling Joshua, Elsamra Sammy E
Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Can J Urol. 2019 Feb;26(1):9660-9663.
To assess whether urologists are able to accurately estimate the cost of commonly used endourologic disposable devices.
An anonymous questionnaire was presented to resident and attending urologists in one academic healthcare system. Respondents estimated the cost of 15 disposable devices commonly used in ureteroscopy. Twenty-five surgeons (9 resident and 16 attending urologists) participated for a response rate of 96.2%. Respondents' cost estimates were compared to actual institutional costs and considered accurate if the absolute percentage error was within 20%. Additional information obtained included: years in practice, participation in purchasing activities, practice setting, number of ureteroscopy procedures performed monthly, degree of confidence in ability to estimate cost, and the importance of cost in device selection for each respondent.
Of 375 total responses, 62 (16.5%) were accurate, 308 (82.1%) were inaccurate, and 5 (1.3%) were unanswered. The mean percentage error (MPE) for all responses was 178.8% (IQR 35.1%-211.4%). Overall, 73% of responses were overestimations and 27% were underestimations. Residents had an MPE of 128.4%, while attending urologists had an MPE of 207.8%. The most inaccurately estimated cost was for an endoscopic y-adapter, while the most accurate estimations were for a 1.5Fr nitinol ureteroscopic stone basket.
Neither attending nor resident urologists are able to accurately estimate the cost of commonly used disposable devices. Improving urologists' understanding of device costs is necessary for improved cost control and a reduction in healthcare expenditures.
评估泌尿外科医生是否能够准确估算常用腔内泌尿外科一次性器械的成本。
向一个学术医疗系统中的泌尿外科住院医师和主治医师发放了一份匿名问卷。受访者估算了输尿管镜检查中常用的15种一次性器械的成本。25名外科医生（9名住院医师和16名主治医师）参与调查，回复率为96.2%。将受访者的成本估算与机构实际成本进行比较，如果绝对百分比误差在20%以内，则认为估算准确。获得的其他信息包括：从业年限、参与采购活动情况、执业环境、每月进行的输尿管镜检查手术数量、对成本估算能力的信心程度，以及成本在每位受访者器械选择中的重要性。
在总共375份回复中，62份（16.5%）准确，308份（82.1%）不准确，5份（1.3%）未作答。所有回复的平均百分比误差（MPE）为178.8%（四分位间距35.1%-211.4%）。总体而言，73%的回复为高估，27%为低估。住院医师的MPE为128.4%，主治医师的MPE为207.8%。成本估算最不准确的是内镜Y形适配器，而最准确的是1.5Fr镍钛诺输尿管镜结石篮。
无论是主治医师还是住院医师，都无法准确估算常用一次性器械的成本。提高泌尿外科医生对器械成本的认识，对于改善成本控制和降低医疗支出是必要的。
