A cost-utility and cost-effectiveness analysis of an acute pain service

Journal of Clinical Anesthesia
Michaela StadlerJean G Boogaerts

Abstract

To analyze, from a societal perspective, the cost-effectiveness and cost-utility of acute pain management after inception of a nurse-based Acute Pain Service (APS) in a general hospital. Open, observational, interventional study. Postanesthesia care unit and surgical wards of a university hospital center. 1975 surgical inpatients who had undergone various types of surgery. Visual analog scale (VAS) pain scores and all systemic analgesics prescribed by anesthesiologists and administered by ward nurses were recorded before and after APS inception. All costs (drugs, disposal, and working time of nurses) related to the APS were identified. Pain measurements were performed by VAS every 4 hours over 3 consecutive days post-surgery and transformed into a health state scale, with 0 being equivalent to absence of pain and 10 to the worst imaginable pain.Using these data, analgesic effectiveness (cost-utility analysis) was expressed as postoperative pain days averted (PPDA) in the two surveys. To perform the cost-effectiveness analysis, we focused on postoperative complications, duration of hospital stay, and postoperative mortality rate. (Note: At the time of the study, 1 EURO = 0.85 US dollars.) VAS pain scores decreased in the post-AP...Continue Reading

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Citations

Sep 23, 2008·Der Orthopäde·H Vogelsang, H Laubenthal
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