-
Tytuł:
-
Reusable, Single-Use, or Both: A Cost Efficiency Analysis of Flexible Ureterorenoscopes After 983 Cases.
-
Autorzy:
-
Van Compernolle D; Department of Urology, Ghent University Hospital, Ghent, Belgium.
Veys R; Department of Urology, Ghent University Hospital, Ghent, Belgium.
Elshout PJ; Department of Urology, Ghent University Hospital, Ghent, Belgium.
Beysens M; Department of Urology, Ghent University Hospital, Ghent, Belgium.
Van Haute C; Department of Urology, University Hospitals Leuven, Leuven, Belgium.
De Groote L; De Beemd, Corporate Finance, Eindhoven, The Netherlands.
Tailly T; Department of Urology, Ghent University Hospital, Ghent, Belgium.
-
Źródło:
-
Journal of endourology [J Endourol] 2021 Oct; Vol. 35 (10), pp. 1454-1459. Date of Electronic Publication: 2021 May 19.
-
Typ publikacji:
-
Journal Article
-
Język:
-
English
-
Imprint Name(s):
-
Original Publication: New York : Mary Ann Liebert, [c1987-
-
MeSH Terms:
-
Kidney Calculi*
Ureteroscopes*
Equipment Design ; Equipment Reuse ; Humans ; Retrospective Studies ; Ureteroscopy
-
Contributed Indexing:
-
Keywords: cost analysis; disposable; flexible ureteroscopy
-
Entry Date(s):
-
Date Created: 20210329 Date Completed: 20211026 Latest Revision: 20211026
-
Update Code:
-
20240105
-
DOI:
-
10.1089/end.2021.0006
-
PMID:
-
33775101
-
Objectives: To determine which flexible ureterorenoscopy program would be most cost-efficient in our center, a cost efficiency analysis and a formula to assess cost efficiency feasibility of a hybrid model were performed. Methods: Total cost per case of reusable flexible ureterorenoscopes (rfURS) was retrospectively calculated and compared with two single-use flexible ureterorenoscopes (sufURS) marketed. A mathematical formula was developed from our data to identify the necessary increase of use of rfURS (NIU-rfURS) to be cost-efficient in a hybrid system utilizing sufURS for only high-risk-of-breakage cases. Results: In 57 months, 983 procedures were performed using 4 digital rfURS (Flex-XC; Storz), necessitating 45 repairs, with a total repair cost of €256.809. Including the capital investment of €24.000 per scope and €60 per sterilization cycle, the cost per case averaged €419 after 983 cases. Consistently using sufURS would have cost 55% to 127% more (respectively, Uscope PU3022 ® and Lithovue ® at €650 and €950 manufacturer suggested retail price). On a per case analysis, the cost was initially extremely high, but declined to reach a plateau around €480 after ∼400 cases. After 155 or 274 procedures, a rfURS program appeared more cost-efficient than consistently using Lithovue or Uscope PU3022, respectively. Based on our data and formula, if we would hypothetically use Uscope PU3022 or Lithovue for 15% of the cases, the NIU-rfURS is, respectively, 28% or 74% (∼6 or 16 cases). The NIU-rfURS increases exponentially with an increased use of sufURS. Conclusion: Consistently using rfURS is more cost-efficient than the constant use of sufURS after 155 to 274 cases. We describe the first mathematical formula that allows a calculation and feasibility assessment of using both reusable and disposable fURS. To identify whether a hybrid system may be a feasible cost-efficient alternative to a rfURS-only program, any center can calculate the NIU-rfURS by entering center-specific data in the formula.