The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Baltimore, MD, 21287, USA.
Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
World J Urol. 2021 Nov;39(11):4275-4281. doi: 10.1007/s00345-021-03724-3. Epub 2021 May 21.
To evaluate the total cost of outpatient flexible cystoscopy associated with reusable device purchase, maintenance, and reprocessing, and to assess potential cost benefits of single-use flexible cystoscopes.
Cost data regarding the purchasing, maintaining, and reprocessing of reusable flexible cystoscopes were collected using a micro-costing approach at a high-volume outpatient urology clinic. We estimated the costs to facilities with a range of annual procedure volumes (1000-3000) performed with a fleet of cystoscopes ranging from 10 to 25. We also compared the total cost per double-J ureteral stent removal procedure performed using single-use flexible cystoscopes versus reusable devices.
The cost associated with reusable flexible cystoscopes ranged from $105 to $224 per procedure depending on the annual procedure volume and cystoscopes available. As a practice became more efficient by increasing the ratio of procedures performed to cystoscopes in the fleet, the proportion of the total cost due to cystoscope reprocessing increased from 22 to 46%. For ureteral stent removal procedures, the total cost per procedure using reusable cystoscopes (range $165-$1469) was higher than that using single-use devices ($244-$420), unless the annual procedure volume was sufficiently high relative to the number of reusable cystoscopes in the fleet (≥ 350 for a practice with ten reusable cystoscopes, ≥ 700 for one with 20 devices).
The cost of reprocessing reusable cystoscopes represents a large fraction of the total cost per procedure, especially for high-volume facilities. It may be economical to adopt single-use cystoscopes specifically for stent removal procedures, especially for lower-volume facilities.
评估与可重复使用设备的购买、维护和再处理相关的门诊软性膀胱镜检查的总费用，并评估一次性软性膀胱镜的潜在成本效益。
使用微观成本法在一家高容量门诊泌尿科诊所收集有关可重复使用软性膀胱镜购买、维护和再处理的成本数据。我们估计了每年进行 1000-3000 例手术的设施的成本，这些手术使用 10-25 个膀胱镜进行。我们还比较了使用一次性软性膀胱镜和可重复使用设备进行单次双 J 输尿管支架取出术的总成本。
根据年度手术量和可用膀胱镜的数量，可重复使用软性膀胱镜的相关费用为每次手术 105-224 美元。随着实践通过增加手术与设备的比例变得更加高效，膀胱镜再处理的总成本比例从 22%增加到 46%。对于输尿管支架取出术，使用可重复使用膀胱镜的每次手术总成本（范围为 165-1469 美元）高于使用一次性设备（244-420 美元），除非年度手术量相对于设备数量足够高（对于有 10 个可重复使用膀胱镜的实践，每年至少为 350 次；对于有 20 个设备的实践，每年至少为 700 次）。
可重复使用膀胱镜的再处理成本占每次手术总成本的很大一部分，尤其是对于高容量设施而言。对于低容量设施，专门为支架取出术采用一次性膀胱镜可能具有经济性。
