The Science Journal of the American Association for Respiratory Care

1999 OPEN FORUM Abstracts

COST MINIMIZATION ANALYSIS OF DOSIMETER-CONTROLLED SMALL VOLUME NEBULIZER THERAPY COMPARED TO STANDARD SMALL VOLUME NEBULIZER THERAPY

Charles R Hall, Sr, BS, RRT, RPFT, R. Randall Baker, PhD, RRT, RCPT. Medical College of Georgia, Augusta, GA.

BACKGROUND: Standard small volume nebulizer (stSVN) therapy is still frequently ordered in the hospital. A survey of area hospitals demonstrated an average >50,000 stSVN floor treatments performed yearly. We have demonstrated that dosimeter-controlled small volume nebulization (dcSVN) gives effective bronchodilation with a short treatment time. Thus, use of dcSVN by a Respiratory Care Practitioner may be a cost effective alternative to stSVN.

Methods: This study used a cost minimization analysis to compare the direct total costs between dcSVN therapy and stSVN therapy to deliver the drug albuterol. Overhead costs, gas delivery equipment, disposable equipment, and medication for each method were assumed to be equal. Therefore, the unique variables for cost analysis were the aerosol delivery time for each method and the capital costs for the dcSVN equipment. A range (10-15 minutes) of aerosol delivery time for stSVN was obtained from the American Association for Respiratory Care's Uniform Reporting Manual 3rd ed. A previous study revealed less than 2 minutes was necessary to deliver a 180 mg dose of albuterol per dcSVN. Cost savings analysis was performed for a hospital with an average of 50,000 stSVN treatments per year for conversions of 25%, 50%, and 75% to dcSVN therapy. Aerosol dose times for each 180 mg (2 minute) level of the dcSVN method from 4 (360 mg) to 14 minutes (1260 mg) was compared to the stSVN method at 10, 12, and 14 minute treatment time levels. Costs were obtained by using a modest $0.25/minute ($15/hour) salary as a baseline. By demonstrating an increase in the number of treatments/hour/employee for both 8 and 12 hour shifts for dcSVN aerosol delivery over stSVN, evaluation of employee position savings (1 full-time employee = 1.0 FTE) was obtained.

Results: Conversion cost savings ($) and FTE position savings are represented below. Any FTE position savings could theoretically result in additional employee benefits savings to the institution, thus, increasing overall costs savings.

stSVN Conversion Savings ($) FTE Savings
dcSVN 25% (12,500 Txs) 50% (25,000 Txs) 75% (37,500 Txs)
min/mg 10 min 12 min 14 min 10 min 12 min 14 min 10 min 12 min 14 min 8 hr shift 12 hr shift
4/360 18,750 25,000 31,250 37,500 50,000 62,500 56,250 75,000 93,750 1.38 1.43
6/540 12,500 18,750 25,000 25,000 37,500 50,000 37,500 56,250 75,000 0.83 0.89
8/720 6,250 12,500 18,750 12,500 25,000 37,500 18,750 37,500 56,250 0.50 0.54
10/900 - 6,250 12,500 - 12,500 25,000 - 18,750 37,500 0.25 0.31
12/1080 - - 6,250 - - 12,500 - - 18,750 0.08 0.14
14/1260 - - - - - - - - - - -

While portable dosimeter systems currently retail for approximately $700 to $1700 per unit, overall costs savings are minimally decreased when comparing dcSVN to the typical 14 minute stSVN.

Conclusions: The

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