Decision Support for the Capacity Management of Bronchoscopy Devices: Optimizing the Cost-Efficient Mix of Reusable and Single-Use Devices Through Mathematical Modeling

Abstract

BACKGROUND: Increasing costs of material resources challenge hospitals to stay profitable. Particularly in anesthesia departments and intensive care units, bronchoscopes are used for various indications. Inefficient management of single- and multiple-use systems can influence the hospitals’ material costs substantially. Using mathematical modeling, we developed a strategic decision support tool to determine the optimum mix of disposable and reusable bronchoscopy devices in the setting of an intensive care unit. METHODS: A mathematical model with the objective to minimize costs in relation to demand constraints for bronchoscopy devices was formulated. The stochastic model decides whether single-use, multi-use, or a strategically chosen mix of both device types should be used. A decision support tool was developed in which parameters for uncertain demand such as mean, standard deviation, and a reliability parameter can be inserted. Furthermore, reprocessing costs per procedure, procurement, and maintenance costs for devices can be parameterized. RESULTS: Our experiments show for which demand pattern and reliability measure, it is efficient to only use reusable or disposable devices and under which circumstances the combination of both device types is beneficial. CONCLUSIONS: To determine the optimum mix of single-use and reusable bronchoscopy devices effectively and efficiently, managers can enter their hospital-specific parameters such as demand and prices into the decision support tool. The software can be downloaded at: https://github.com/drdanielgartner/bronchomix/.

Single-Use (Disposable) Flexible Bronchoscopes: The Future of Bronchoscopy?

“…There is a procedure number at which RFBs become more cost-effective than SUFBs [ 15 , 35 ] with mathematical modelling tools available to assess the cost-effective number of RFBs or SUFBs that should be purchased whilst allowing for locally variable factors. When device demand is incorporated into these algorithms, there is a suggestion that units performing a smaller number of interventions could manage solely with SUFBs whilst RFBs become more economical with increased demand [ 36 ] and it is likely to be cost-effective to have a subset of SUFBs available for emergency use [ 16 , 36 ]. To date, no studies have been published looking at the cost-effectiveness of SUFBs in a respiratory setting, and the costs associated with RFB maintenance and repair in an anaesthesia department may not be comparable.…”

Single Use or Disposable Flexible Bronchoscopes: Bench Top and Preclinical Comparison of Currently Available Devices

“…[1][2][3][4][5][6][7][8][9] Principally due to portability, accessibility, and the lack of requirement for cleaning and storage, single use or disposable flexible bronchoscopes (SUFBs) were already popular in operating room (OR) and intensive care units (ICUs). 3,[10][11][12][13][14][15] Pulmonologists started using SUFBs prior to the COVID-19 pandemic [15][16][17] and there was an increase thereafter for several reasons including portability and lack of a requirement of staff and personal protective equipment to clean and transport scopes. 15,18,19 In parallel, international bodies recommended switching from reusable to single-use devices 20 with the Emergency Care Research Institute listing contamination of scopes as a top 10 health technology hazard.…”