Punch Donna, Davis Jonathan S, Hahn Rebecca, Gill Rav, Hsiao Chia-Wen, Kara Richard
Kensington Eye Institute (Retired), Toronto, Ontario, Canada.
KJT Group, Inc, Rochester, NY, USA.
Clinicoecon Outcomes Res. 2023 Mar 1;15:151-164. doi: 10.2147/CEOR.S397671. eCollection 2023.
Surgical procedure packs are commonly used in ophthalmological surgeries, but quantitative evidence demonstrating the time efficiency and economic impact of their use is limited. Evaluating the time and cost of surgical pack use is particularly important for publicly funded healthcare systems with tight budgets and/or an emphasis on value-based care. This study sought to estimate the economic impact of comprehensive surgical pack use in cataract and vitreoretinal (retina) surgeries across operating room (OR), materials management, and accounting departments in Canada.
A budget impact model developed for the United States (US) from a self-reported cross-sectional study was adapted for Canada. The US study obtained data via an online survey and timing exercises of surgical procedures. The model was adapted using relevant Canadian-specific labor and cost inputs. Use of generic commodity packs (no proprietary equipment-specific supplies) was compared to full utilization of Custom-Pak, a comprehensive pack (disposables plus equipment-specific supplies) in cataract and retina surgeries at the facility and aggregate group (provincewide) levels.
Switching from generic to comprehensive pack use in all 2500 cataract procedures at a community hospital saves 287 labor hours per year, primarily in the materials management department. Surgery preparation (OR) hours saved allow for an additional 196 potential procedures annually. Most of the Canadian Dollar (CAD) $39,815 annual cost savings are realized for the OR. Aggregating across 50,000 cataract surgeries at the provincial level yields savings of 5608 hours and 3916 additional procedures, translating to hidden cost reductions of CAD$790,632 annually. Implementing full Custom-Pak use at the facility level in 1000 retina cases saves $10,650 annually; provincewide, 127 potential additional procedures can be gained.
Comprehensive Custom-Pak use improves efficiency in cataract and retina surgeries saving substantial time and cost in Canadian hospitals, potentially allowing more patients to have these procedures, and reducing wait times.
手术器械包常用于眼科手术，但证明其使用的时间效率和经济影响的定量证据有限。对于预算紧张和/或强调基于价值的医疗的公共资助医疗系统而言，评估手术器械包使用的时间和成本尤为重要。本研究旨在估计在加拿大手术室、材料管理和会计部门进行白内障和玻璃体视网膜（视网膜）手术时使用综合手术器械包的经济影响。
根据一项自我报告的横断面研究为美国开发的预算影响模型被改编用于加拿大。美国的研究通过在线调查和手术时间记录来获取数据。该模型使用了加拿大特定的相关劳动力和成本投入进行改编。在机构和总体组（全省范围）层面，将通用商品器械包（无专用设备特定耗材）的使用与全面使用Custom-Pak（一种综合器械包，包括一次性用品和设备特定耗材）在白内障和视网膜手术中的情况进行了比较。
在一家社区医院的所有2500例白内障手术中，从使用通用器械包改为使用综合器械包每年可节省287个工时，主要节省在材料管理部门。节省的手术准备（手术室）工时使得每年可额外进行196例潜在手术。手术室每年可实现约39,815加元的成本节省。在省级层面，对50,000例白内障手术进行汇总计算，可节省5608个工时和额外的3916例手术，相当于每年隐性成本降低790,632加元。在1000例视网膜手术的机构层面全面使用Custom-Pak每年可节省10,650加元；在全省范围内，可额外进行127例潜在手术。
全面使用Custom-Pak可提高白内障和视网膜手术的效率，在加拿大医院节省大量时间和成本，有可能使更多患者能够接受这些手术，并减少等待时间。
