Table 3B:
Cost Saving Calculation: Nebulizer + Metered-dose inhalers (MDI)
| unit | calculation | UChicago Medicine Internal Model | External Model | Reference | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Scenario 1 | Scenario 2 | Scenario 3 | Scenario 1 | Scenario 2 | Scenario 3 | ||||||
| Nebulizer (Neb) + Metered-dose inhalers (MDI) | |||||||||||
| Neb | |||||||||||
| Medication | |||||||||||
| Number of patients | # | a’ | 0 | 276 | 442 | 0 | 276 | 442 | -- | ||
| Number of administrations per patient | # | b’ | 5 | 5 | 5 | 5 | 5 | 5 | Assume that number of neb administration per patient is 5 when transitioning to MDI after neb. | ||
| Cost (Neb) | $ | c’ | 0.16 | 0.16 | 0.16 | 0.16 | 0.16 | 0.16 | The actual cost of neb per administration at UChicago Medicine. | ||
| Sub total | $ | d’=a’*b’*c’ | 0 | 221 | 353 | 0 | 221 | 353 | -- | ||
| Labor (Respiratory Therapist; RT) | |||||||||||
| Number of patients | # | e’ | 0 | 276 | 442 | 0 | 276 | 442 | -- | ||
| Number of administrations per patient | # | f’ | 5 | 5 | 5 | 5 | 5 | 5 | Assume that number of neb administration per patient is 5 when transitioning to MDI after neb. | ||
| RT time per administration | hour | g’ | 0.25 | 0.25 | 0.25 | 0.25 | 0.25 | 0.25 | Assume that Respiratory Therapist need 0.25 hour per administration. | ||
| Hourly labor cost | $ | h’ | 29 | 29 | 29 | 29 | 29 | 29 | US Bureau of Labor Statistics (data as of September 4, 2019) | ||
| Sub total | $ | i’=e’*f’*g’*h’ | 0 | 9,998 | 15,997 | 0 | 9,998 | 15,997 | -- | ||
| Neb total cost | $ | j’=d’+i’ | 0 | 10,219 | 16,350 | 0 | 10,219 | 16,350 | -- | ||
| MDI | |||||||||||
| Medication | -- | ||||||||||
| Number of patients | # | k | 0 | 276 | 442 | 0 | 276 | 442 | -- | ||
| Number of administrations per patient | # | l | 1 | 1 | 1 | 1 | 1 | 1 | Assume that number of MDI medication to patient is one. | ||
| Cost (Albuterol MDI) | $ | m | 21 | 21 | 21 | 21 | 21 | 21 | The actual cost of Albuterol MDI per patient at UChicago Medicine. | ||
| Cost (Spacer) | $ | n | 0 | 0 | 0 | 4.7 | 4.7 | 4.7 | UChicago Medicine doesn’t use spacer for MDI. | ||
| Sub total | $ | o=k*l*(m+n) | 0 | 5,785 | 9,256 | 0 | 7,085 | 11,336 | -- | ||
| Labor | |||||||||||
| Pharmacist teaching students | At UChicago Medicine students at Pharmacy school are engaged in training patients to use MDI. | ||||||||||
| Teaching time | hour | p | 0 | 35 | 35 | 0 | 0 | 0 | Pharmacist spent 35 hours to teach students about how to train patients. | ||
| Hourly teaching labor cost | $ | q | 0 | 65 | 65 | 0 | 0 | 0 | Assume that pharmacist hourly salary is $65 at UChicago Medicine. | ||
| Sub total | $ | r=p*q | 0 | 2,275 | 2,275 | 0 | 0 | 0 | |||
| Pharmacist | Assume that pharmacists don’t directly train patients about how to use MDI in the external model. | ||||||||||
| Number of patients | # | s | 0 | 0 | 0 | 0 | 276 | 442 | |||
| Number of administrations per patient | # | t | 0 | 0 | 0 | 1 | 1 | 1 | Assume that number of training per patient is one. | ||
| Pharmacist time per administration | hour | u | 0 | 0 | 0 | 0.25 | 0.25 | 0.25 | Assume that pharmacist spends 0.25 hours per training. | ||
| Hourly pharmacist labor cost | $ | v | 0 | 0 | 0 | 61 | 61 | 61 | US Bureau of Labor Statistics (data as of September 4, 2019) | ||
| Sub total | $ | w=s*t*u*v | 0 | 0 | 0 | 0 | 4,184 | 6,695 | -- | ||
| Sub total | $ | x=r+w | 0 | 2,275 | 2,275 | 0 | 4,184 | 6,695 | -- | ||
| MDI total cost | $ | y=o+x | 0 | 8,060 | 11,531 | 0 | 11,269 | 18,031 | -- | ||
| Neb + MDI total cost | $ | z=j’+y | 0 | 18,279 | 27,881 | 0 | 21,488 | 34,381 | -- | ||
| Total cost | $ | j+z | 60,830 | 48,694 | 40,047 | 60,830 | 51,903 | 46,547 | -- | ||
| Reference | |||||||||||
| Total medication cost | $ | d+d’+o | 1,314 | 6,663 | 9,872 | 1,314 | 7,963 | 11,952 | -- | ||
| Total labor cost | $ | i+i’+x | 59,515 | 42,031 | 30,175 | 59,515 | 43,940 | 34,595 | -- | ||
| % of total medication cost | % | (d+d’+o)/(j+z) | 2.2% | 13.7% | 24.7% | 2.2% | 15.3% | 25.7% | -- | ||
| % of total labor cost | % | (i+i’+x)/(j+z) | 97.8% | 86.3% | 75.3% | 97.8% | 84.7% | 74.3% | -- | ||