Cost awareness of disposable surgical equipment and strategies for improvement: cross sectional survey and literature review

A Survey of the Estimated Cost of Surgical Consumable Items Within Trauma and Orthopaedic Departments

Introduction The impact of the current economic and environmental climate, both nationally and globally, is further straining the NHS. This has led to scrutiny of high-expenditure areas, including consumables. Clinician's knowledge surrounding health economics is sparse, and we conducted this survey to assess cost-awareness within the Trauma and Orthopaedic (T&O) departmental staff. Methods A questionnaire was digitally distributed to T&O staff in the East Kent Hospitals Trust. This included demographic data and to make estimations of the cost of 10 specialty-specific items. The data were analysed to determine the average, median, and interquartile range (IQR) of the estimated prices and compared to the actual costs. Results Approximately 7.1% of all item estimates were deemed 'correct'. No correlation was seen between years of staff experience and the accuracy of estimates. 'Kenalog 1 mL ampoule' (Kenalog, Bristol-Myers Squibb, NJ) had the highest accuracy of estimation across all responses (13%), whilst both 'kirschner wires' and '3.2 drill bit' had the lowest accuracy (4% each). The median estimated cost was closest to the actual cost for 'cement pack' (median estimate/actual cost = 0.9). The median estimated cost was furthest from the actual cost for 'tourniquet cuffs' (median estimate/actual cost = 0.16). 'Velcro wrist splint' was the item that was the most overestimated (median estimate/actual cost = 1.57), with only two of the 10 items being overestimated ('velcro wrist splint' and 'dynamic hip screw and plate'). The most underestimated item was 'tourniquet cuffs' (median estimate/actual cost = 0.16). Conclusions There is a paucity of knowledge surrounding the cost of specialist T&O consumables. The limitations included the sample size (98 respondents) and geographical area (East Kent Hospitals Trust). This study shows that there is a need for further research into this topic, with long-term outcomes, which may be beneficial both economically and environmentally.

The role of human capital and stress for cost awareness in the healthcare system: a survey among German hospital physicians

BACKGROUND

Germany has the highest per capita health care spending among EU member states, but its hospitals face pressure to generate profits independently due to the government's withdrawal of investment cost coverage. The diagnosis related groups (DRG) payment system was implemented to address the cost issue, challenging hospital physicians to provide services within predefined prices and an economic target corridor to reduce costs. This study examines the extent of cost awareness among medical personnel in German hospitals and its influencing factors.

METHODS

We developed an online survey in which participants across all specialties in hospitals estimated the prices in euros of four common interventions and answered questions about their human capital and perceived stress on the workplace. As a measure of cost awareness, we used the probability of estimating the prices correctly within a reasonable margin. We employed logit logistic regression estimators to identify influencing factors in a sample of 86 participants.

RESULTS

The results revealed that most of the respondents were unaware of the costs of common interventions. General human capital, acquired through prior education, and job-specific human capital had no influence on cost awareness, whereas domain-specific human capital, that is, gaining economic knowledge based on self-interest, had a positive nonlinear effect on cost awareness. Furthermore, an increased stress level negatively influenced cost awareness.

CONCLUSIONS

This paper is the first of its kind for the German health care sector that contributes responses to the question whether health care professionals in German hospitals have cost awareness and if not, what reasons lie behind this lack of knowledge. Our findings show that the cost awareness desired by the introduction of the DRG system has yet to be achieved by medical personnel.

Multilayer-structured fibrous membrane with directional moisture transportability and thermal radiation for high-performance air filtration

The demand of high-performance filter media for the face masks is urgent nowadays due to the severe air pollution. Herein, a highly breathable and thermal comfort membrane that combines the asymmetrically superwettable skin layer with the nanofibrous membrane has been fabricated via successive electrospinning and electrospraying technologies. Thanks to high porosity, interconnected pore structure, and across-thickness wettability gradient, the composite membrane with a low basis weight of 3.0 g m−2 exhibits a good air permeability of 278 mm s−1, a comparable water vapor permeability difference of 3.61 kg m−2 d−1, a high filtration efficiency of 99.3%, a low pressure drop of 64 Pa, and a favorable quality factor of 0.1089 Pa−1, which are better than those of the commercial polypropylene. Moreover, the multilayer-structured membrane displays a modest infrared transmittance of 92.1% that can keep the human face cool and comfort. This composite fibrous medium is expected to protect humans from PM2.5 and keep them comfortable even in a hygrothermal environment.

Electret nanofibrous membrane with enhanced filtration performance and wearing comfortability for face mask

Airborne particulate matter (PM) pollution has become a serious threat to human health, thus it is highly desired for a high-filtration-performance and good-wearing-comfort face mask. Herein, a highly breathable and thermal comfort filter medium consisting of electret polyethersulfone/barium titanate nanofibrous membrane (PES/BaTiO₃ NFM) integrated on a nonwoven polypropylene substrate was developed. Benefiting from the high porosity and optimized injection charge energy, the PES/BaTiO₃ membrane was endowed with a good air permeability of 743 mm s^-1, a modest water vapor permeability of 6.24 kg m^-2 d^-1, and an enhanced charge storage stability. In addition, the electret PES/BaTiO₃ NFM1.5 medium with a low basis weight of 4.32 g m^-2 still shows a high filtration efficiency of 99.99% and a low pressure drop of 67 Pa after being treated at 200 °C for 45 min, which is better than that of commercial media. Moreover, 3D simulation based on the characters of composite membrane was processed to graphically express the airflow distribution during the filtration process. Significantly, the NFM1.5 with a high infrared (IR) transmittance of 93.4% led to an effective radiative cooling to human body radiation. This multifunctional fibrous medium design may provide new insights into the development of environmental adaptive protection materials.