Hyperbare Zuurstoftherapie: Rapid Assessment - KCE

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70 Hyperbaric Oxygenation Therapy <strong>KCE</strong> Reports 74 Table 21. Equipment maintenance cost data Mean equipment maintenance cost (€) % of investment price Multiplace chamber 6 persons 10 650 1.5 % (range: 1% – 2 %) Multiplace chamber 12 persons 12 000 1.5 % (range: 1% – 2 %) Monoplace chamber 2 100 1.5 % (range: 1% – 2 %) 5.9.2.3 Oxygen and compressed air cost The assumptions on oxygen and compressed air costs are presented in Table 22. Table 22. Oxygen and compressed air cost calculation Oxygen Cost/Consumption Source Unit cost of oxygen €0.5 / m3 (€0.5 / 1000 liter) (Estimate St Jan Brugge) Oxygen consumption Compressed air 50 liter / min * 90 min €2.25 per patient per session (Estimate St Jan Brugge) Cost of compressed air €1 per session (Estimate St Jan Brugge) 5.9.2.4 Patient consumables Patient consumables are estimated at €7 per patient (source: UZ Antwerpen) for materials such as masks and filters. Since the number of sessions varies both between and within indications, we preferred to calculate the cost per session. To calculate the total cost per patient, the number of sessions should be multiplied with the cost per session and the consumable cost per patient should be added. 5.9.2.5 Overhead: property, maintenance, heating and general costs It is important to note that the general overhead costs (such as property, maintenance, heating and other general costs) are already covered by the hospital financing (part A1 and B1). However, in order to make the cost overview complete, these cost factors are also included in this cost study. Overhead costs are calculated based on data obtained from UZ Antwerpen, AZ St Jan Brugge and UCL. Property costs cover the depreciation of the building. General overhead covers the following items: internal patient transport, internal and external transport of consumables, taxes, insurance costs, religious service and mortuary. Maintenance costs cover the following costs: cleaning personnel, cleaning products, general technical maintenance, security and utilities (water, gas, electricity). Heating costs cover both the fuel and heating engineer costs. See Table 23 for an overview of these cost items. Table 23. Property and general overhead costs (€ per m2) Average of 3 hospitals Depreciation of building 42.02 General overhead 42.38 Maintenance 73.16 Heating 15.91 Total 173.47 The following floor space assumptions are made in order to determine these overhead costs (Table 24):
<strong>KCE</strong> Reports 74 Hyperbaric Oxygenation Therapy 71 Table 24. Floor space assumptions for overhead costs Floor space assumptions Source Monoplace 13.5 m 2 Treweek et al. 133 (“3m x 4.5m x 3m”) 6-persons chamber 65 m 2 AZ St Jan Brugge 12-persons chamber 88 m 2 UZ Antwerpen 5.9.3 Overview of analyzed scenarios Different scenarios were simulated according to chamber size, average number of sessions per day, and average occupancy rate of the chamber. Concerning chamber size, three scenarios are analyzed: a monoplace chamber, a six- and a 12-place chamber. Most of the Belgian centres can be put into one of these three categories (see section 5.6). Furthermore, there are three scenarios on the average number of sessions per day, i.e. one, two or three. Theoretically, up to four sessions could be given per day. Currently, however, only up to two sessions are given at the Belgian centres. Therefore, we restrict our analysis to the three proposed scenarios. Finally, four scenarios on the occupancy rate are analyzed: 30%, 50%, 70% and 90%. These are the approximate occupancy rates that were actually observed at Belgian hospitals (see section 5.7.1). By combining all these scenarios, 36 outcomes are obtained (Figure 31). However, not all of these scenarios are realistic, e.g. a chamber with 3 sessions per day with occupancy rate of only 30%, since it would reasonable to assume that instead one or two sessions per day would be given with a higher occupancy rate. However, for the completeness of the exercise, no scenarios were omitted. Figure 31. Overview of scenarios 5.9.4 Variables with probability distribution functions Many of the input variables in this cost analysis are estimates of costs that in reality can be quite variable and uncertain. For some of these uncertain values we therefore determined probability distribution functions. The following distribution functions were applied (see Table 25).
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