Hyperbare Zuurstoftherapie: Rapid Assessment - KCE

68 Hyperbaric Oxygenation Therapy KCE Reports 74
A monoplace chamber must be inspected at ten years and if satisfactory can be used for
another ten years. In line with the MSAC (2000) report 69 and analysis of Treweek et
al. 133 , an average lifetime of ten years is assumed for monoplace chambers.
An annual equivalent cost (AEC) was calculated over a period of 25 and ten years for a
multi- and monoplace, respectively. According to the KCE guidelines, 134 a discount rate
of 3% was applied using the following formula: 72
5.9.2 Operational costs
K = AEC + AEC/(1 + r) + AEC/(1 + r) 2 + … AEC/(1 + r) n-1
AEC = K / (An-1,r + 1)
• AEC = annual equivalent cost
• n = useful life of equipment
• r = discount rate (3%)
• A(n,r) = the annuity factor (n years at interest rate r)
• K = purchase price
In this cost analysis, the operational costs contain the following items: personnel,
equipment maintenance, oxygen and compressed air, patient consumables, general
maintenance, and overhead.
5.9.2.1 Personnel requirements
According to ECHM recommendations, a minimum work force is necessary to ensure
safety. For a multiplace chamber, a physician, a care-attendant (nurse) and an operator
should be present. For a monoplace chamber, only a physician and an operator are
required. We assumed that the physician is still able to perform other tasks at e.g. the
emergency unit. A 50% presence for HBOT was assumed. Additionally, a person for
emergency assistance should be available. Furthermore, there are also personnel costs
for the management and administration of the hyperbaric chamber.
In most centres, a session takes 90 minutes. In some centres, however, a number of
breaks are given, increasing the required time to 99, 110 or 120 minutes. We took into
account the shortest treatment session of 90 minutes. On top of this, another 30 to 60
minutes per session is required for patient assessment, treatment preparation and
quality assurance. 69 An overview of our assumptions is provided in Table 16, Table 17
and Table 18. In order to calculate the total number of sessions that can be given per
year, it is assumed that the chamber is operated 5 days per week and 48 weeks per
year.
Table 16. Required time and personnel during a treatment session
For multiplace scenarios
Patient assessment, treatment preparation and finalization
and quality assurance
Required time Required personnel
60 min 1 physician (50%)
1 nurse
Patient treatment 90 min 1 physician (50%)
1 attendant (nurse)
1 operator (nurse)
For monoplace scenarios
Patient assessment, treatment preparation and finalization
and quality assurance
60 min 1 physician (50%)
1 nurse
Patient treatment 90 min 1 physician (50%)
1 operator (nurse)