Cost-effectiveness of forced air warming during sedation in the cardiac catheterisation laboratory

Abstract

Aim: The aim of this study was to determine the cost-effectiveness of forced air warming (FAW) during sedation in a cardiac catheterisation laboratory.

Background: Forced air warming improves thermal comfort in comparison with standard care. It is not known whether the extra costs required for FAW are good value.

Design: Cost-effectiveness analysis alongside a randomized controlled trial conducted in 2016-2017.

Methods: A cost-effectiveness analysis was undertaken using Monte Carlo simulations from input distributions to estimate costs and effects associated with using FAW to reduce risk of thermal discomfort for patients receiving sedation in a cardiac catheterisation laboratory. A range of willingness to pay threshold values were tested with results plotted on a cost-effectiveness acceptability curve. Costs were calculated in Australian currency ($AUD).

Results: Estimated total costs were $5.21 (SD 3.26) higher per patient for FAW in comparison to standard care. Estimated probability of success (rating of thermal comfort) was 0.16 (0.06) higher for FAW. Forced air warming becomes more likely to result in a net benefit than standard care at a willingness to pay threshold of $34.

Conclusion: Forced air warming could be considered cost-effective for procedures performed with sedation in a cardiac catheterisation laboratory if the extra cost of an incremental gain in thermal comfort is less than the decision maker's willingness to pay for it. Therefore, those responsible for decision-making regarding use of FAW in the cardiac catheterisation laboratory can use results of our model to decide if it represents good value for their organisation.

Keywords: conscious sedation; cost-effectiveness; deep sedation; health economics; healthcare costs; hypothermia; nurses; nursing.