Die Behandlung der intraoperativen Hypotonie im Spiegelbild des klinischen Prozessmanagements - Eine prospektive pharmakoökonomische Analyse

Zielsetzung: Intraoperativ auftretende Hypotonien werden in Deutschland hauptsächlich mit Akrinor® als Bolusgabe oder mit Noradrenalin mit Hilfe eines Perfursors® behandelt. Dem niedrigeren Einkaufspreis von Noradrenalin steht ein zeitlich aufwendiger Vorbereitungsprozess gegenüber. Ziel ist es, du...

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Bibliographic Details
Main Author: Ortmeier, Jennifer
Contributors: Höltermann, Walter (PD Dr. med.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2018
Online Access:PDF Full Text
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Objective: Intraoperative hypotension is mainly treated with Akrinor® as a bolus dose or with noradrenaline with the help of a Perfusor® in Germany. The lower purchase price of noradrenaline is accompanied by a time-consuming preparation process. The aim is to draw a comparison from an economic perspective through the exact analysis of the process costs of the two treatment options. Methods and results: This is a prospective pharmacoeconomic study. A total of 231 patient cases with 345 measurements from six German hospitals were recorded and evaluated between December 2015 and March 2016. 55.84 % of these cases were initially treated with Akrinor® and 44.16 % were initially treated with noradrenaline. The major difference between the two treatment processes is the different application form of the two medications. The subprocess bolus dose makes up 1,29 € of the total personnel costs per application and the subprocess Perfusor® makes up 6,54 € of the personnel costs. As a result of this process cost analysis the initial treatment with Akrinor® produces total costs of 5,18€ and the initial treatment with noradrenalin produces total costs of 6,63 €. The cost difference of 1,45 € of the two treatment alternatives enables the possibility of cost-reducing process optimization. The average personnel engagement time for the initial treatment with Akrinor® is 74 seconds per case. In contrast, there is an average engagement time of 215 seconds per case for the initial treatment with noradrenalin, if, as usual, the drug is administered by using a Perfusor®. Conclusions: The results of this study show that the initial treatment of intraoperative hypotension with Akrinor® is more cost-effective than the initial treatment with noradrenalin and that the application of activity - based costing in the context of clinical process management is a suitable instrument for comparing the efficiency of alternative medical treatment processes.