title: Activity-based cost analysis of opioid-related nausea and vomiting among inpatients.
abstract: OBJECTIVE
  Nausea and/or vomiting (N/V) are frequent side effects of opioid drugs. These are of major concerns to patients and caregivers and only few studies have focused on their economical costs.
  
  
  METHODS
  This is a prospective, nonproduct-related, activity-based evaluation of personnel and material costs of opioid-related N/V among inpatients.
  
  
  METHODS
  Data were obtained from surgical, general medicine, and palliative care wards at 16 German hospitals of different size, healthcare mandate, and ownership.
  
  
  METHODS
  According to predefined criteria, of 462 documented N/V events, 340 were diagnosed as opioid related.
  
  
  METHODS
  Elicited activities and pharmacological interventions for N/V episodes followed local standards.
  
  
  METHODS
  Both materials used and the time engaged to treat patients with N/V were documented on an "ad hoc" activity recording form. The total cost of an opioid-related N/V episode was calculated based on standard wages of the involved personnel and standard costs of the inherent materials used.
  
  
  RESULTS
  Mean staff tenure time for handling an episode of N/V was 26.2 ± 19.8 minutes (nausea 16.9 ± 28.7 minutes; nausea + vomiting: 33.4 ± 26.8 minutes). In the German context, this corresponds to average personnel costs of €18.06 ± 13.64. Material cost contributes to another €13.49 ±13.38 of costs mainly depending on acquisition costs of antiemetic drugs.
  
  
  CONCLUSIONS
  N/V showed to have impact on workload of nurses and (to lesser extent) physicians and economic burden of €31 ± 22 for each N/V episode. In view of these results, the potential costs of strategies to minimize the incidence of N/V (use of antiemetics and/or the use of new analgesics) should be outweighed against the incurred costs of N/V.
authors.affiliation: Department of Anesthesiology & Intensive Care Medicine, Philipps-University Marburg, Marburg, Germany.
authors.forename: Leopold
authors.initials: L
authors.lastname: Eberhart
authors.affiliation: Department of Anesthesiology & Intensive Care Medicine, Philipps-University Marburg, Marburg, Germany.
authors.forename: Tilo
authors.initials: T
authors.lastname: Koch
authors.affiliation: Department of Anesthesia and Critical Care, University of Würzburg, Würzburg.
authors.forename: Peter
authors.initials: P
authors.lastname: Kranke
authors.affiliation: Department of Anesthesiology & Intensive Care Medicine, Philipps-University Marburg, Marburg, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Rüsch
authors.affiliation: Department of Anesthesiology & Intensive Care Medicine, Philipps-University Marburg, Marburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Torossian
authors.affiliation: Department of Anesthesiology & Intensive Care Medicine, Philipps-University Marburg, Marburg, Germany; 5Med GmbH, Bad Abbach, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Nardi-Hiebl
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000932:Antiemetics / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D005858:Germany; D017721:Hospital Costs; D006801:Humans; D007297:Inpatients; D008297:Male; D008505:Medical Staff, Hospital / Q000191:economics; D008875:Middle Aged; D018803:Models, Economic; D009325:Nausea / Q000139:chemically induced / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D009741:Nursing Staff, Hospital / Q000191:economics; D011446:Prospective Studies; D012456:Salaries and Fringe Benefits; D013997:Time Factors; D014839:Vomiting / Q000139:chemically induced / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D016526:Workload
chemical_list: D000701:Analgesics, Opioid; D000932:Antiemetics