Switching to Single-use Flexible Ureteroscopes for Stones Management: Financial Impact and Solutions to Reduce the Cost Over a 5-Year Period - 28/08/20
Abstract |
Objectives |
To assess the financial impact of switching to single-use ureteroscopes (sURS) in urolithiasis management for a hospital, over a 5-year period, and to identify possible solutions to contain or reduce it.
Methods |
A Budget Impact (BI) model was designed for a public hospital performing around 200 ureteroscopies or extracorporeal shockwave lithotripsies per year. The BI was estimated as the difference between financial balances (between costs and revenues) of 2 environments (with and without sURS). The population was defined as adults treated for urolithiasis. The BI model was based on assumptions about the expected progression in the incidence of urolithiasis, and the expected change in clinical practices due to the availability of sURS. We considered the costs and revenues of hospital stays, the purchase price of sURS and the costs of digital or fiberoptic reusable ureteroscopes (rURS). Univariate and multivariate sensitivity analyses were performed.
Results |
The cumulative 5-year financial impact of switching completely to sURS was €807,824 and €649,677 in comparison with fiberoptic and digital rURS respectively. This impact could be reduced by half or more if the health-care facility were to adopt different solutions, including negotiating the purchase price of sURS, developing outpatient activity and reducing production costs for ureteroscopy procedures.
Conclusion |
The BI model gives decision-makers a more accurate picture of the financial impact of switching to sURS and highlights ways to reduce the expected additional cost.
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| Compliance with Ethical Standards: This article does not contain any studies with human participants or animals performed by any of the authors. The data used are either freely accessible on the Agency for Information on Hospital Care (AIHC) website (www.scansante.fr) or from the University Hospital of Tours hospital database (PMSI data). |
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| This observational study on aggregated data does not require registration. |
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| All data generated or analyzed during this study are included in this published article and in the supplementary material (except for confidential data). |
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| Funding: No funding was received for conducting this study. |
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| Author contributions: BP initiated the research topic. BP and BFA brought their experience to value the key model parameters. SW and TLF performed the microcosting. ER provided PMSI data. SDR, FM and SBH performed the data collection, designed the model, performed the statistical analysis and wrote the initial manuscript in collaboration with BP. All authors have read and approved the final manuscript. SBH is the general guarantor. |
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| Disclosure:The authors declare no relationship of interest likely to have affected the study methodology or results. |
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| Franck Bruyère declared himself as proctor for the Boston Scientific Society. |
Vol 143
P. 68-74 - septembre 2020 Retour au numéro
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