Reliability, cost-effectiveness, and safety of reuse of ancillary devices for ERCP

Prat, Frédéric; Spieler, Jean-François; Paci, Sabine; Pallier, C.; Fritsch, Jacques; Choury, André-Daniel; Pelletier, G; Raspaud, Sylvie; Nordmann, Patrice; Buffet, Catherine

doi:10.1016/s0016-5107(04)01685-2

Cited by 28 publications

(18 citation statements)

References 17 publications

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“…54 Another study showed that the median number of efficient uses for a reusable, double-lumen sphincterotome is 8, with no increased risk of infectious complications when they are properly reprocessed. 55 The CPT Ò codes for diagnostic ERCP and sphincterotomy are included in Table 3.…”

Section: Financial Considerationsmentioning

confidence: 99%

ERCP cannulation and sphincterotomy devices

Kethu¹,

Adler²,

Conway³

et al. 2010

Gastrointestinal Endoscopy

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Section: Financial Considerationsmentioning

confidence: 99%

ERCP cannulation and sphincterotomy devices

Kethu¹,

Adler²,

Conway³

et al. 2010

Gastrointestinal Endoscopy

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“…Other papers in this category report on current reuse and reprocessing practices in different medical facilities and regions [13][14][15], while others focus more on logistical and implementation aspects of reprocessing [16,17]. Several studies have examined the costs and benefits of reusable devices versus disposable devices [18][19][20], and while they touch on some related issues, they do not directly address the question posed by this paper. First, they do not address the issue of reprocessing, which involves reusing devices which are labeled as disposable.…”

Section: Relevant Literaturementioning

confidence: 99%

Safety-cost trade-offs in medical device reuse: a Markov decision process model

Sloan

2006

Health Care Manage Sci

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Healthcare expenditures in the US are approaching 2 trillion dollars, and hospitals and other healthcare providers are under tremendous pressure to rein in costs. One cost-saving approach which is gaining popularity is the reuse of medical devices which were designed only for a single use. Device makers decry this practice as unsanitary and unsafe, but a growing number of third-party firms are willing to sterilize, refurbish, and/or remanufacture devices and resell them to hospitals at a fraction of the original price. Is this practice safe? Is reliance on single-use devices sustainable? A Markov decision process (MDP) model is formulated to study the trade-offs involved in these decisions. Several key parameters are examined: device costs, device failure probabilities, and failure penalty cost. For each of these parameters, expressions are developed which identify the indifference point between using new and reprocessed devices. The results can be used to inform the debate on the economic, ethical, legal, and environmental dimensions of this complex issue.

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“…13,14,16,27 Evidence of the clinical significance of residual contamination or mechanical failure reported in vitro is lacking, however, and other reports have indicated that reuse of certain disposable devices is safe, ethical, and cost-effective. 12,[28][29][30][31] By subjecting this disposable port and its components to repeated cycles of simulated use, decontamination, and sterilization, our goal was to mimic the physical fatigue experienced by the port in a clinical setting. We have demonstrated that VHP is effective at eliminating bacteria from the ports despite the physical fatigue that may occur with multiple uses.…”

Section: Discussionmentioning

confidence: 99%