Cost-effectiveness of infusion pumps to reduce errors in a Pediatric ICU

To analyze cost-effectiveness and to calculate incremental cost-effectiveness ratio of the use of infusion pumps with drug library to reduce errors in intravenous drug administration in pediatric and neonatal patients in Intensive Care Units.

Methods:

Mathematical modeling for economic analysis of the decision tree type. The base case was composed of reference and alternative settings. The target population was neonates and pediatric patients hospitalized in Pediatric and Neonatal Intensive Care Units, comprising a cohort of 15,034 patients. The cost estimate was based on the bottom-up and top-down approaches.

Results:

The decision tree, after RollBack, showed that the infusion pump with drug library may be the best strategy to avoid errors in intravenous drugs administration.

Conclusion:

The analysis revealed that the conventional pump, although it has the lowest cost, also has lower effectiveness.

Descriptors:
Nursing; Technology Assessment, Biomedical; Cost-Benefit Analysis; Pharmaceutical Preparations; Drug-Related Side Effects and Adverse Reactions

Type	Name (distribution)	Description	Alpha	Lambda Beta
gamma	dist cost hosp sp	distribution of hospitalization costs with smart pump	(7186.28^2) (4165.544^2)	7186.28/(4165.544^2)
beta	dist_efe_sp	distribution of discharge effectiveness with cp without ade	((0.9064^2) *(1-0.9064)/(0.04044^2))	(0.9064(1-0.9064)/(0.04044^2))-((0.9064^2)(1-0.9064)/(0.04044^2))
beta	dist_efe_cp	distribution of effectiveness of cp	((0.74^2) *(1-0.74)/(0.1697^2))	(0.74(1-0.74)/(0.1697^2))-((0.74^2)(1-0.74)/(0.1697^2))
gamma	dist hosp cost cp	distribution hospitalization costs using conventional pump	(6381.88^2)/(4165.544^2)	6381.88/(4165.544^2)
gamma	dis_costs_ade	distribution of costs with ade	(72480.00^2)/(25568.981^2)	72480.00/(25568.981^2)
beta	dist dose erro prob	distribution of the dose error probability	((0.26^2)*(1-0.26)/(0.1697^2))	(0.26(1-0.26)/(0.1697^2))-((0.26^2)(1-0.26)/(0.1697^2))
beta	dist sev ade prob	distribution of occurrence of severe ade probability	((0.023^2)*(1-0.023)/(0.001414^2))	(0.023(1-0.023)/(0.001414^2))-((0.023^2)(1-0.023)/(0.001414^2))
beta	dist_death prob_sev ade	distribution of death probability by severe ade	((0.03^2)*(1-0.03)/(0.04242^2))	(0.03(1-0.03)/(0.04242^2))-((0.03^2)(1-0.03)/(0.04242^2))

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[1] Corresponding Author: Roberto Carlos Lyra da Silva. E-mail: prolyra@gmail.com