Resource Utilisation And Costs Associated With Intravenous Patient-Controlled Analgesia Morphine For Post-Operative Pain Management In A Teaching Hospital Setting In Ireland

Abstract

Information regarding resource utilisation, hospital logistics, and costs associated with intravenous patient-controlled analgesia (IV PCA) morphine treatment is limited. In this prospective study, conducted between March 2016 and June 2016 in The Adelaide and Meath, incorporating The National Children’s Hospital (AMNCH), Tallaght, these aspects of treatment with IV PCA-morphine were examined. Information about IV PCA morphine related staff time and resource use were recorded for patients (n = 25) who had undergone elective surgery. The nature of IV PCA-morphine complications, e.g. problems with drugs or pumps, were also recorded. The unit cost of each staff member and resource used for an episode of treatment with IV PCA-morphine were derived from national and local sources. The time required by staff and resource costs was calculated to generate a per-patient cost estimate of an episode of treatment with IV PCA-morphine. An episode of IV PCA-morphine treatment lasted on average 1.7 days and had a mean cost of €148.20. This cost was made up of staff time (68%), pump costs (1.1%) and consumable costs (29.6%). The mean time spent by staff on IV PCA-morphine treatment tasks over the course of treatment in the recovery room and on the ward was 124 minutes (Recovery room (39 minutes), Ward (85 minutes). Patients enrolled into this study were 56% male, with an ASA health classification of I or II (92%). 60% were on a concomitant medication prior to their procedure, and 20% required additional analgesic treatment during recovery. Substantial staff time and costs are associated with IV PCA-morphine treatment. In the light of these costs, exploration of the potential availability of less costly alternatives are recommended