title: Cost comparison of re-usable and single-use fibrescopes in a large English teaching hospital.
abstract: A number of studies in the U.S.A. and mainland Europe have described the costs of fibreoptic tracheal intubation. However, no such data from the UK appear available. We performed a cost assessment of fibreoptic intubation, using re-usable (various devices from Olympus, Acutronic and Karl Storz) and single-use (Ambu aScope) fibrescopes, at the Queens Medical Centre, Nottingham, U.K., between 1 January 2009 and 31 March 2014. The total annual cost of fibreoptic intubation with re-usable fibrescopes was £46,385. Based on 141 fibreoptic intubations per year, this equated to £329 per use, an average dominated by repair/maintenance costs (43%) and capital depreciation costs (42%). In comparison, the total annual cost of using single-use fibrescopes for the same work would have been around £200 per use. The analysis enabled us to develop a generic model, wherein we were able to describe the relationship between total cost of use vs number of uses for a fibrescope. An 'isopleth' was identified for this relationship: a line that joined all the points where the cost of re-usable vs single-use fibrescopes was equal. It appears cheaper to use single-use fibrescopes at up to 200 fibreoptic intubations per year (a range commensurate with normal practice) even when the repair rate for re-usable fibrescopes is low. Any centre, knowing its fibrescope use and repair rate, can plot its data similarly to help ascertain which of the re-usable or single-use fibrescope represents better value.
authors: Department of Anaesthesia, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors: R A
authors: RA
authors: McCahon
authors: School of Economics, University of Nottingham, Nottingham, UK.
authors: D K
authors: DK
authors: Whynes
mesh_terms: D003365:Costs and Cost Analysis; D004209:Disposable Equipment / Q000191:economics* / Q000706:statistics & numerical data; D017743:Equipment Reuse / Q000191:economics*; D005336:Fiber Optic Technology / Q000191:economics* / Q000295:instrumentation*; D006784:Hospitals, Teaching / Q000191:economics*; D006801:Humans; D007442:Intubation, Intratracheal / Q000191:economics* / Q000295:instrumentation*; D020704:Laryngoscopes; D018803:Models, Economic; D013242:Sterilization / Q000191:economics; D006113:United Kingdom