Key result
Procedural sedation adverse events are linked to ~$2.2 billion in additional annual US healthcare costs.
Why the study?
The impact of sedation-related adverse events on health care costs and resource use is not well understood.
What is the clinical and economic burden of procedural sedation-related adverse events?
Cross-Sectional (n=127)
Double-blind
Yes
What is the clinical and economic burden of procedural sedation-related adverse events?
Sedation-related adverse events, even minor ones, significantly increase healthcare costs and cause procedural delays or cancellations.
Survey data link sedation AEs to higher costs; leaves open precise burden and mitigation strategies pending prospective studies.
Background: Studies have reported on the incidence of sedation-related adverse events (AEs), but little is known about their impact on health care costs and resource use. Methods: Health care providers and payers in five countries were recruited for an online survey by independent administrators to ensure that investigators and respondents were blinded to each other. Surveys were conducted in the local language and began with a “screener” to ensure that respondents had relevant expertise and experience. Responses were analyzed using Excel and R, with the Dixon’s Q statistic used to identify and remove outliers. Global and country-specific average treatment patterns were calculated via bootstrapping; costs were mean values. The sum product of costs and intervention probability gave a cost per AE. Results: Responses were received from 101 providers and 26 payers, the majority having >5 years of experience. At a minimum, the respondents performed a total of 3,430 procedural sedations per month. All AEs detailed occurred in clinical practice in the last year and were reported to cause procedural delays and cancellations in some patients. Standard procedural sedation costs ranged from €74 (Germany) to $2,300 (US). Respondents estimated that AEs would increase costs by between 16% (Italy) and 179% (US). Hypotension was reported as the most commonly observed AE with an associated global mean cost (interquartile range) of $43 ($27–$68). Other frequent AEs, including mild hypotension, bradycardia, tachycardia, mild oxygen desaturation, hypertension, and brief apnea, were estimated to increase health care spending on procedural sedation by $2.2 billion annually in the US. Conclusion: All sedation-related AEs can increase health care costs and result in substantial delays or cancellations of subsequent procedures. The prevention of even minor AEs during procedural sedation may be crucial to ensuring its value as a health care service.
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Saunders et al. (2018) conducted a cross-sectional in Procedural sedation-related adverse events (n=127). Procedural sedation-related adverse events was evaluated on Impact on health care costs and resource use. Procedural sedation-related adverse events were estimated to increase costs by 16% to 179%, with minor events potentially adding $2.2 billion annually to US healthcare spending.
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