[Economical assessment of intravenous mixture centralization].
OBJECTIVE
To evaluate the cost of preparing intravenous mixtures in the centralized pharmacy service of the hospital as compared to the cost of their preparation by nurses on wards, assuming that the results are clinically analogous for the patients.


METHODS
A cost-minimization analysis has been carried out. Data concerning types of mixtures and quantities has been analyzed retrospectively. The fixed and variable costs in both drug preparation options have been assessed using the real costs of the hospital in 2003. This study considered the productive time of nurses in our hospital as well as time described in bibliography. The materials used and their cost has been quantified, along with the cost of recycled mixtures. A sensitivity analysis was conducted considering the most influential variables.


RESULTS
The preparation times of nurses in pharmacy are equal or shorter. The material costs/100 intravenous mixtures represent a fifth part in pharmacy (1.10 euro compared to 5.69-12.37 euro). The minimum ratio of cost between pharmacy and ward was 1:2.94 (10,619:31,265 euro) and the maximum was 1:3.77 (37,075:139,633 euro). The savings due to recycling of intravenous mixtures (36,168 to 118,110 euro) always favours the pharmacy. The sensibility analysis indicates that centralization maintains the usefulness level (ratio total annual cost 1:3.23), with a ratio of minimum annual productive time between pharmacy and ward nurses of 1:3.5.


CONCLUSIONS
In our hospital the preparation of intravenous mixtures at the pharmacy department minimizes costs compared to preparation on wards, allowing nurses to devote more time to patient care, and thus improving the efficiency of management.
Martínez-Tutor
M J
MJ
Servicio de Farmacia, Complejo Hospitalario San Millán-San Pedro, Logroño, La Rioja, Spain. mmartinezt@sefh.es
D002497:Centralized Hospital Services / Q000191:economics* / Q000458:organization & administration; D003363:Cost Control; D003362:Cost-Benefit Analysis; D004339:Drug Compounding / Q000191:economics / Q000295:instrumentation; D016527:Drug Costs; D017598:Efficiency, Organizational / Q000191:economics / Q000706:statistics & numerical data; D017721:Hospital Costs; D006757:Hospital Units / Q000191:economics / Q000458:organization & administration; D006769:Hospitals, General / Q000191:economics / Q000458:organization & administration; D006784:Hospitals, Teaching / Q000191:economics / Q000458:organization & administration; D006801:Humans; D007262:Infusions, Intravenous; D024802:Nurse's Role; D010607:Pharmacy Service, Hospital / Q000191:economics* / Q000458:organization & administration; D012996:Solutions / Q000191:economics*; D013030:Spain; D013997:Time Factors
D012996:Solutions