A comprehensive literature-based equation to compare cost-effectiveness of a flexible ureteroscopy program with single-use versus reusable devices.
Cost-Benefit Analysis
Kidney Calculi
Ureteroscopy
Journal
International braz j urol : official journal of the Brazilian Society of Urology
ISSN: 1677-6119
Titre abrégé: Int Braz J Urol
Pays: Brazil
ID NLM: 101158091
Informations de publication
Date de publication:
Historique:
received:
03
01
2019
accepted:
20
04
2019
entrez:
10
8
2019
pubmed:
10
8
2019
medline:
24
9
2019
Statut:
ppublish
Résumé
To critically review all literature concerning the cost-effectiveness of flexible ureteroscopy comparing single-use with reusable scopes. A systematic online literature review was performed in PubMed, Embase and Google Scholar databases. All factors potentially affecting surgical costs or clinical outcomes were considered. Prospective assessments, case control and case series studies were included. 741 studies were found. Of those, 18 were duplicated and 77 were not related to urology procedures. Of the remaining 646 studies, 59 were considered of relevance and selected for further analysis. Stone free and complication rates were similar between single-use and reusable scopes. Operative time was in average 20% shorter with digital scopes, single-use or not. Reusable digital scopes seem to last longer than optic ones, though scope longevity is very variable worldwide. New scopes usually last four times more than refurbished ones and single-use ureterorenoscopes have good resilience throughout long cases. Longer scope longevity is achieved with Cidex and if a dedicated nurse takes care of the sterilization process. The main surgical factors that negatively impact device longevity are lower pole pathologies, large stone burden and non-use of a ureteral access sheath. We have built a comprehensive fi nancial costeffective decision model to fl exible ureteroscope acquisition. The cost-effectiveness of a fl exible ureteroscopy program is dependent of several aspects. We have developed a equation to allow a literature-based and adaptable decision model to every interested stakeholder. Disposable devices are already a reality and will progressively become the standard as manufacturing price falls.
Identifiants
pubmed: 31397987
doi: 10.1590/S1677-5538.IBJU.2018.0880
pii: IBJU20180880
pmc: PMC6837614
doi:
Types de publication
Comparative Study
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
658-670Informations de copyright
Copyright® by the International Brazilian Journal of Urology.
Déclaration de conflit d'intérêts
None declared.
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