麻醉学主导的心脏植入式电子设备服务的经济评估

Economic Evaluation of Anesthesiology-Led Cardiac Implantable Electronic Device Service.

作者信息

Zaky Ahmed, Melvin Ryan L, Benz David, Davies James, Panayotis Vardas, Maddox William, Shah Ruchit, Lynch Tom, Beck Adam, Hearld Kristine, McElderry Tom, Treggiari Miriam

机构信息

Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL 35205, USA.

Department of Surgery, Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL 35205, USA.

出版信息

Healthcare (Basel). 2023 Jun 27;11(13):1864. doi: 10.3390/healthcare11131864.

DOI:10.3390/healthcare11131864

PMID:37444698

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10341216/

Abstract

BACKGROUND

Implementation of an anesthesiology-led cardiac implantable electronic device (CIED) service can be viewed to have economic and efficiency challenges. This study evaluates the cost savings of an anesthesiology-led CIED service.

METHODS

A total of 830 patients presented in the pre-implementation period from 1 March 2016 to 31 December 2017, and 1981 patients presented in the post-implementation period from 1 January 2018 to 31 October 2021. Interrupted time-series analysis for single-group comparisons was used to evaluate the cost savings resulting from reduction in operating room (OR) start delays for patients with CIEDs.

RESULTS

OR start-time delay was reduced by 10.6 min (95%CI: -20.5 to -0.83), comparing pre- to post-implementation. For an OR cost of USD 45/min, we estimated the direct cost to the department to be USD 1.68/min. The intervention translated into a total cost reduction during the intervention period of USD 250,000 (USD 18,000 to USD 470,000) per year for the institution and USD 9800 (USD 730 to USD 17,000) per year for the department. The yearly cost of employing a full-time team of CIED specialists would have been USD 135,456. The service triggered electrophysiology consultation on 13 device malfunctions.

CONCLUSIONS

An anesthesiology-led CIED service resulted in substantial cost savings, increased OR efficiency and patient safety.

摘要

背景

实施由麻醉科主导的心脏植入式电子设备（CIED）服务可能会面临经济和效率方面的挑战。本研究评估了由麻醉科主导的CIED服务所节省的成本。

方法

在2016年3月1日至2017年12月31日的实施前期共有830例患者，在2018年1月1日至2021年10月31日的实施后期共有1981例患者。采用单组比较的中断时间序列分析来评估因减少CIED患者的手术室（OR）开始延迟而节省的成本。

结果

与实施前相比，实施后OR开始时间延迟减少了10.6分钟（95%CI：-20.5至-0.83）。对于OR成本为每分钟45美元，我们估计该科室的直接成本为每分钟1.68美元。该干预措施使该机构在干预期间每年总成本降低25万美元（1.8万美元至47万美元），科室每年降低9800美元（730美元至1.7万美元）。雇佣一组全职CIED专家的年度成本原本为135,456美元。该服务触发了针对13次设备故障的电生理会诊。