Date and Time
November 3, 2004
1:30 PM - 3:00 PM

Availability
Open to the public
No RSVP required

Speaker
Harrison Chow, MD - Clinical instructor and perioperative management fellow in the Department of Anesthesia at Stanford Medical Center

BACKGROUND: In recent years, adherence to hospital accounting guidelines regarding the use of X-ray-detectable surgical sponges and other instruments during surgery has reduced the incidence of foreign objects unintentionally remaining in the body after surgery. However, the problem of so-called "retained foreign bodies," though rare, continues to persist, causing hardship for patients, embarrassment to physicians and hospitals, and requiring considerable expenditures of time, money and other resources for the affected hospitals. Surgical sponges constitute the majority of retained foreign-body cases.

OBJECTIVE: The goal of this study was to perform an incremental cost-effectiveness analysis of the use of Radiofrequency Identification-Tagged (or RFID-tagged) surgical sponges.

METHODS: The study employed a spreadsheet economic model incorporating a review of retained foreign body literature; analysis of past and current methods of prevention; published counting and X-ray protocols; estimates of associated physician and hospital costs; and closed-claims analysis of the cost of retained sponges. The base-case was a hypothetical 50-year old male undergoing elective colon resection for cancer at an inpatient hospital facility.

RESULTS: The study found that standard sponges in the base-case cost $68.24 per surgical case, as compared with $71.06 for the RFID sponges. The majority of the cost for standard sponges was related to operating-room time necessary for nurses to manually count the sponges. For RFID sponges, the largest cost component was for purchasing costs. Overall, the incremental cost effectiveness ratio equaled $41,704. The quality-adjusted life-years (QALYs) gained with RFID sponges was related to improvements in mortality and quality of life for those patients who were discharged home with a retained sponge.

CONCLUSION: RFID-tagged surgical sponges appear to be economically attractive from society's perspective, as long as this new technology approximately cuts in half the time nurses spend counting sponges in the OR. Surprisingly, the researchers' results were not sensitive to liability costs.

Location
Health Research & Policy Building
(Redwood Building), Room T138-B
259 Campus Drive
Stanford University
Stanford, CA 94305
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FSI Contact
Sara L. Selis