Bojic, Suzana; Ladjevic, Nebojsa; Palibrk, Ivan; Soldatovic, Ivan; Likic-Ladjevic, Ivana; Meissner, Winfried; Zaslansky, Ruth; Stamer, Ulrike M; Baumbach, Philipp; Stamenkovic, Dusica (2023). Cost-effectiveness of the Perioperative Pain Management Bundle a registry-based study. Frontiers in Public Health, 11(1157484), p. 1157484. Frontiers Research Foundation 10.3389/fpubh.2023.1157484
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INTRODUCTION
The Perioperative Pain Management Bundle was introduced in 10 Serbian PAIN OUT network hospitals to improve the quality of postoperative pain management. The Bundle consists of 4 elements: informing patients about postoperative pain treatment options; administering a full daily dose of 1-2 non-opioid analgesics; administering regional blocks and/or surgical wound infiltration; and assessing pain after surgery. In this study, we aimed to assess the cost-effectiveness of the Bundle during the initial 24 h after surgery.
MATERIALS AND METHODS
The assessment of cost-effectiveness was carried out by comparing patients before and after Bundle implementation and by comparing patients who received all Bundle elements to those with no Bundle element. Costs of postoperative pain management included costs of the analgesic medications, costs of labor for administering these medications, and related disposable materials. A multidimensional Pain Composite Score (PCS), the effectiveness measurement, was obtained by averaging variables from the International Pain Outcomes questionnaire evaluating pain intensity, interference of pain with activities and emotions, and side effects of analgesic medications. The incremental cost-effectiveness ratio (ICER) was calculated as the incremental change in costs divided by the incremental change in PCS and plotted on the cost-effectiveness plane along with the economic preference analysis.
RESULTS
The ICER value calculated when comparing patients before and after Bundle implementation was 181.89 RSD (1.55 EUR) with plotted ICERs located in the northeast and southeast quadrants of the cost-effectiveness plane. However, when comparing patients with no Bundle elements and those with all four Bundle elements, the calculated ICER was -800.63 RSD (-6.82 EUR) with plotted ICERs located in the southeast quadrant of the cost-effectiveness plane. ICER values differ across surgical disciplines.
CONCLUSION
The proposed perioperative pain management Bundle is cost-effective. The cost-effectiveness varies depending on the number of implemented Bundle elements and fluctuates across surgical disciplines.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy > Partial clinic Insel 04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy |
UniBE Contributor: |
Stamer, Ulrike |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2296-2565 |
Publisher: |
Frontiers Research Foundation |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
26 Sep 2023 14:58 |
Last Modified: |
29 Oct 2023 02:24 |
Publisher DOI: |
10.3389/fpubh.2023.1157484 |
PubMed ID: |
37744520 |
Uncontrolled Keywords: |
Bundle acute postoperative pain cost-effectiveness cost-effectiveness plane economic preference analysis incremental cost-effectiveness ratio international pain outcomes questionnaire pain composite score |
BORIS DOI: |
10.48350/186570 |
URI: |
https://boris.unibe.ch/id/eprint/186570 |
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