OHP-020 A single use kit for cataract surgery: why not?

Abstract

BackgroundIn 2015, approximately 1500 cataract surgeries were performed in our teaching hospital. Currently, surgeons use single use (SU) medical devices (MD) and multiple use (MU) instruments for cataract operation without vitrectomy. In the context of development of ambulatory care, optimisation is key. Several pharmaceutical laboratories offer an ‘SU cataract kit’ with all MD including instrumentation.PurposeTo perform a medicoeconomic analysis comparing current practices versus practices with the ‘SU cataract kit’.Material and methodsA cost minimisation study was conducted during the summer of 2016 in the ophthalmic surgical unit. Firstly, practical observations were performed by a pharmacy resident to describe the kit contents. Then, this listing was approved by surgeons. Several pharmaceutical laboratories were contacted to offer a price for this kit. In a second investigation, the cost of this kit was compared with the unit price of each SU-MD and the cost of instrument sterilisation. The preparation time by nurses and pre-disinfection time by care assistants were also measured.ResultsCurrently, surgeons used 15 SU-MD in unitary bag and 4 MD-MU in sterilised boxes. All 15 SU-MD cost €20.03. The mean cost per sterilised box, for 4 instruments (speculum, bonn clip, capsulorhexis clip, micromanipulator) was €17. Therefore, MD used for one cataract operation cost €37€. The cataract kit should contain 19 MD. 3 pharmaceutical laboratories responded to our request and the best kit selected cost €52.5. The preparation time by nurses and pre-disinfection time by care assistants were, respectively, 30 min and 5 min per operation. Using the kit, preparation time would be reduced to 5 min and no pre-disinfection would be required. Thus time savings of 30 min would mean operation on more than 4 patients per day. In France, the diagnosis related group (02C05J) tariff for cataract surgery is €1265.74. Therefore, our hospital could hope to obtain more revenues.ConclusionThe SU kit had a higher purchase cost than the SU-MD and MU instruments currently used. However, the use of the SU kit would provide gains due to an increase in the number of operated patients. Furthermore, the use of the SU kit could facilitate ambulatory care.No conflict of interest