BACKGROUND: Parenteral nutrition (PN) can be administered with separate bottles or as commercially prepared all-in-one systems. The aim of this study was to evaluate the overall cost of PN using the 3-compartment bag vs standard multibottle system. METHODS: Overall costs of hospital PN were calculated from expenditures (solutions, consumable items, and staff costs). Time that staff spent preparing the PN was measured to determine personnel costs; bottom-up costing was used to assign a monetary value. Standard treatment algorithms of a 10-day course of PN for a standard 70-kg patient were specified for both systems. One-way sensitivity analyses were performed to test the robustness of the model's conclusions. RESULTS: The daily total cost of the 3-compartment bag system was euro42.26 per patient whereas the total cost of the separate bottle system was euro51.62, resulting in a cost saving of euro9.36 per patient with the 3-compartment bag system. For 10 days of treatment, PN costs euro422.51 per patient for the 3-compartment system vs euro516.16 for the multibottle system. Sensitivity analyses showed that the difference in costs between the 2 systems was maintained in the face of changes in patients' nutrition requirements and personnel costs. CONCLUSIONS: The costs associated with PN using a 3-compartment bag system were lower than those associated with a multibottle system. Given the established therapeutic equivalence of the 2 systems, this study shows the 3-compartment bag system to be the system of choice to reduce costs.
BACKGROUND: Parenteral nutrition (PN) can be administered with separate bottles or as commercially prepared all-in-one systems. The aim of this study was to evaluate the overall cost of PN using the 3-compartment bag vs standard multibottle system. METHODS: Overall costs of hospital PN were calculated from expenditures (solutions, consumable items, and staff costs). Time that staff spent preparing the PN was measured to determine personnel costs; bottom-up costing was used to assign a monetary value. Standard treatment algorithms of a 10-day course of PN for a standard 70-kg patient were specified for both systems. One-way sensitivity analyses were performed to test the robustness of the model's conclusions. RESULTS: The daily total cost of the 3-compartment bag system was euro42.26 per patient whereas the total cost of the separate bottle system was euro51.62, resulting in a cost saving of euro9.36 per patient with the 3-compartment bag system. For 10 days of treatment, PN costs euro422.51 per patient for the 3-compartment system vs euro516.16 for the multibottle system. Sensitivity analyses showed that the difference in costs between the 2 systems was maintained in the face of changes in patients' nutrition requirements and personnel costs. CONCLUSIONS: The costs associated with PN using a 3-compartment bag system were lower than those associated with a multibottle system. Given the established therapeutic equivalence of the 2 systems, this study shows the 3-compartment bag system to be the system of choice to reduce costs.
Authors: R S Turpin; C Solem; A Pontes-Arruda; M Sanon; S Mehta; F Xiaoqing Liu; M Botteman Journal: Eur J Clin Nutr Date: 2014-03-26 Impact factor: 4.016