A micro-costing study: comparing a standard intravenous patient-controlled analgesia system with a novel sublingual patient-controlled analgesia system.

Abstract

Judicious spending in healthcare is of paramount importance, particularly when introducing new devices or interventions. These products or interventions need to be economically efficient both directly and indirectly. An accepted method of cost estimation is micro-costing. Micro-costing involves direct enumeration and costing of every input consumed in the treatment of a particular patient when using new device, medicine or intervention. In our study, we investigated the cost of using a novel sublingual (SL) patient-controlled analgesia (PCA) device and compared it with our conventional intravenous (IV) PCA device. A previous study performed in our institution produced a cost per use of IV PCA device at €97. This compared with a previous European study published in this journal in 2010 which showed a similar figure of €96 per use of IV PCA device. In our comparative study, we used a case record form (CRF) to incorporate a cost to all consumables used, staff time and equipment used to both the SL PCA and the IV PCA. A total of 60 patients of similar demographic were included in our study. The cost of an IV PCA episode was €97.89 and €182.32 for an SL PCA episode. Standl et al. (2010) showed that the average cost of an IV PCA episode was €96.40 with 78% of this being made up of staff time. SL PCA was more efficacious in certain patient groups and in certain surgical groups. After performance of a micro-costing study, the less costly IV PCA episode was statistically significant compared with a SL PCA episode. However, the associated staff costs were less with a SL PCA episode. We performed a micro-costing study on a novel sublingual PCA device and compared it with a conventional intravenous PCA device. All resources were included and compared.