Cost benefit analysis of portable disposable patient-controlled epidural analgesia pump under the diagnosis procedure combination based payment system

BACKGROUND: The aim of this study was to assess how portable disposable patient-controlled epidural analgesia (PCEA) pumps (P group) affect the total costs of postoperative pain management compared with ordinary continuous epidural analgesia pumps without patient-controlled analgesia(C group). METHODS: The hospital income, material costs and costs of drugs for postoperative analgesia were analyzed in 446 surgical patients (C group) between April 2005 and November 2005 and in 417 surgical patients (P group) between April 2006 and November 2006, respectively. RESULTS: Considerable cost savings were achieved when PCEA pumps was used (C group--1300 yen/per patient; P group + 1950 yen/per patient). CONCLUSIONS: PCEA pumps itself work out as designated insured medical materials and additional drugs for postoperative analgesia in the ward is cleared under the diagnosis procedure combination (DPC)-based payment system. Clearance of PCEA pumps under the DPC-based payment system and cost savings of additional drugs for postoperative analgesia in the ward contributed to increases in the profit of the hospital. The DPC-based payment system may offer an economic incentive to introduction of PCEA.