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