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COST-IDENTIFICATION ANALYSIS OF AN ACUTE PAIN SERVICE.

Department of Anesthesia & Department of Medical Affairs, Sunnybrook & Women’s College Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada

INTRODUCTION

Economic studies are needed to support decision-making and planning of perioperative services. In spite of high interest to the economic implications of an acute pain service (APS), there is a shortage of publications on this issue. The data about costs related to an APS are controversial. The purpose of this study is to evaluate two models of an APS staffing in terms of costs.

METHODS

To identify costs of an APS we used monthly cost center reports for six consecutive months. To evaluate different models of APS functioning we used break-even analysis. The analysis calculates a break-even point based on fixed costs, variable costs per patient, and savings per patient. Physicians’ reimbursement cost calculations was not included in the evaluated models since it is not a part of the APS budget.

RESULTS

The APS, staffed with 1.5 Acute Care Nurse Practitioner’s (ACNP’s) and supervised by anesthesiology, consuls an average of 278 new patients/month. The average duration of patients on the APS is 4 days. Based on the results of cost-identification and break-even analysis and considering one- months APS budget average per-patient variable cost of the APS is 67.02CAD. Increasing the APS staff at Sunnybrook campus to three ACNP’s will increase average per-patient variable cost up to 122.72CAD. According to this model the APS budget would increase from 239,670CAD to 439,172CAD/year, whilst keeping the break-even point at only 34 patients per month.

DISCUSSION

Reported average per-patient APS costs are highly variable from 3 USD to 242 USD. The costs are related to many factors, including the type of healthcare system organization, APS staffing and functioning, and whether the calculations are made for patients in a ward or an ICU (43 – 247 USD). Our findings correspond to these data. According to the break-even analysis, increasing the APS staffing to three ACNP’s will have a relatively small impact on the budget, while striving for a reduced length of stay, improvement in patients satisfaction and meeting accreditation standards in pain management.

REFERENCES

Pain. 1994 Apr; 57(1): 117–23.[Medline]

Best Pract Res Clin Anaesthesiol. 2002 Dec; 16(4): 527–47.[Medline]

Eur J Anaesthesiol. 2000 Sep; 17(9): 566–75.[Medline]

This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Souzdalnitski, D. Articles by Avila, A. Search for Related Content PubMed Articles by Souzdalnitski, D. Articles by Avila, A.