The pharmacy cost of delivering postoperative analgesia to patients undergoing joint replacement surgery

Macario, Alex; McCoy, Mark

doi:10.1054/jpai.2003.2

Cited by 24 publications

(8 citation statements)

References 27 publications

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“…The patients had a 1-h personal interview with the dietician before and after the 8-week period of once-weekly team therapy, i.e., the total time spent per patient was 3.5 h. Add to this the daily cost of about 10 US dollars, which is the average price of Speasy Ò LED nutrition powder. Taken over 56 days, as a substitute for all other meals, the total cost for the outpatient clinic will thus be far less than 1000 US dollars for the entire 8-week period, which is considerably cheaper than most other treatment alternatives in OA 62 . The number of visits in the intervention group was high compared with the control group.…”

Section: Discussionmentioning

confidence: 99%

Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial

Christensen

Astrup

Bliddal

2005

Osteoarthritis and Cartilage

299

256

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Section: Discussionmentioning

confidence: 99%

Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial

Christensen

Astrup

Bliddal

2005

Osteoarthritis and Cartilage

299

256

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“…Consideration of the cost of IV PCA errors relative to the cost of therapy is important. Macario and McCoy examined pharmacy-related costs associated with postoperative analgesia following hip, knee, and bilateral knee replacement 40 and found that the average pharmacy cost ranges from $560 to $922 per event.…”

Section: Discussionmentioning

confidence: 99%

The Rate and Costs Attributable to Intravenous Patient-Controlled Analgesia Errors

et al. 2009

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Purpose To estimate the rates and costs of intravenous patient-controlled analgesia (IV PCA) errors from the hospital or integrated health system perspective. Methods This study used a cost-accounting methodology to estimate the costs attributable to IV PCA errors in the United States. Data for the study were obtained from the MEDMARX and Manufacturer and User Facility Device Experience (MAUDE) datasets, published literature, and expert opinions. MEDMARX is a voluntary, anonymous, medication-error-reporting database owned and operated by the United States Pharmacopeia. MAUDE is a mandatory, device-error-reporting database maintained by the US Food and Drug Administration. Levels of care rendered as a result of the IV PCA errors were estimated by applying clinical assumptions (validated by an expert advisory panel) to each of the 7 error consequences considered in this analysis. Variable and opportunity costs (2006 values) were considered, including medication, laboratory, lost revenue, and labor. The corresponding costs were applied to the error consequences to derive the estimated mean cost for each error cause. The numbers of errors documented in each dataset and the published literature were used to extrapolate the rate of IV PCA errors annually. Results The average cost per error event was $733 in the MEDMARX dataset and $552 in the MAUDE dataset. Harmful IV PCA errors were 120 to 250 times more costly than nonharmful errors. The annual error rates were estimated as 407 IV PCA-related errors and 17 device-related errors per 10,000 people within the United States. Conclusion: Analysis of 2 datasets, MEDMARX and MAUDE, revealed that IV PCA medication- and device-related errors are costly to hospitals and integrated health systems and represent a significant burden on the US health system. This study provided a novel approach to estimating the associated costs of undesired IV PCA-related events. Additional research is needed to validate the methodology (as applied to this area) and results.

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“…With bottom-up costing, more precise economic measurements of the perioperative period are possible [7,8]. When this is done, it becomes clear that the most expensive day for a surgical patient in the hospital is the first one, when the procedure takes place.…”

Section: "Top-down" Costingmentioning

confidence: 99%

What does one minute of operating room time cost?

Macario

2010

Journal of Clinical Anesthesia

Self Cite

580

333

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The pharmacy cost of delivering postoperative analgesia to patients undergoing joint replacement surgery

Cited by 24 publications

References 27 publications

Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial

Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial

The Rate and Costs Attributable to Intravenous Patient-Controlled Analgesia Errors

What does one minute of operating room time cost?

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