Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

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9. Sadovnikoff N. Varon J, Sternbach GL. Carbon monoxide poisoning. An occult epidemic. Postgraduate Medicine 1992;92:86-96. [Narrative review.] 10. Samuels AH, Vamos MJ, Taikato MR. Carbon monoxide, amnesia and hyperbaric oxygen therapy. Australian and New Zealand Journal of Psychiatry 1992;26:316-9. [Case report.] 11. Severance HW. Kolb JC, Carlton FB, Jorden RC. Acute carbon monoxide poisoning: emergency management and hyperbaric oxygen therapy. Journal of the Mississippi State Medical Association 1989;30:321-5. [Case series.] 12. Tomaszewski C. Carbon monoxide poisoning. Early awareness and intervention can save lives. Postgraduate Medicine 1999;105:39-50. [Narrative review.] 114 <strong>Hyperbaric</strong> oxygen therapy
Appendix E Calculation of monoplace unit costs Capital costs The total cost per year, comprising both capital costs and costs of operating a hyperbaric monoplace unit, has been estimated. The number of sessions (treatments) and courses of treatments (patients) per year have also been estimated to compute costs per session and costs per course of treatment., number of sessions and courses of treatment per year An average of 90 minutes per treatment is required per session, 2 but this is expected not to allow for patient assessment and patient preparation. The duration of time required to turn around a chamber is estimated to be 2 to 2.5 hours. The number of sessions per day for a monoplace unit is estimated to be 4, the estimated maximum feasible number of sessions in an 8-hour day. The number of sessions per day is varied to 3 in sensitivity analysis. The number of sessions per year with 4 sessions per day is then calculated to be 960, using a 5-day working week and 48 weeks per year (estimated 48-50 weeks in operation per year). Each course of treatment is expected to comprise 20-30 sessions (from the assessment report). An estimate of 30 sessions per course of treatment was used in the analysis. The estimated 960 sessions per year is then estimated to be equivalent to 32 courses of treatment per year. The cost of a hyperbaric monoplace unit has been estimated to range from A$100,000 to A$233,000. An acrylic chamber could cost US$90,000-US$120,000(A$137,000- A$183,000) with about A$50,000 on top for a fit out of the suite of rooms including oxygen supply. A steel chamber costs $100,000 to $150,000 (indicated by a manufacturer in Melbourne). A monoplace unit costs A$120,000 to A$230,000 (personal communication from applicant). A capital and installation cost of A$300,000 was also given. Discussions with experts in the field suggested an estimate of A$200,000. This is used in all the primary analyses. It is within the range of costs for an acrylic chamber. A sensitivity analysis on the cost of a unit from A$100,000 to A$300,000 was also conducted. The cost of capital is assumed to be 9% per annum. The commercial rates for the cost of borrowing (personal communication from applicant) are 8-10%. The sensitivity analysis used a 5% cost of capital per annum. The estimated effective life of the monoplace unit is 10 years (personal communication from applicant). A sensitivity analysis was conducted using an effective life of 30 years (estimated life of steel and acrylic monochambers). The capital cost per annum is calculated as the constant payment required per year, with the expected cost of capital, effective life and present value of the capital equipment. In the primary case, the capital cost per annum is estimated to be $31,164. The capital cost per session is $32.46. The capital cost per course of treatment is $974. <strong>Hyperbaric</strong> oxygen therapy 115
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Hyperbaric Oxygen Therapy November
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Contents Executive summary.........
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Tables Table 1 Measures of disease
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Table 45 Functional neurologic scor
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Figures Figure 1. Outline of search
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Effectiveness Published guidelines
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evidence that exposure to HBO may b
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No available evidence No evidence w
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Introduction The Medicare Services
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Multiplace chambers can accommodate
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Marketing status of the device The
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Table 3 1998 - 1999 self-reported d
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Table 6 retrieval. Indication-speci
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Phase of Search Initial Search Ful
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Conduct of meta-analysis When the d
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early as 1995. The guidelines - kno
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Table 10 Minimum staff qualificatio
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Is it effective? The review assesse
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Table 14 Patient criteria of includ
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offered ample details. The remainin
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characteristics compared to the tre
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Assessment of heterogeneity All the
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Odds ratio 10 1 0.1 0.01 A sensitiv
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Wound healing Two of the five ident
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Studies of necrotising soft tissue
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Summary Table 25 Survival in patien
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Table 29 Therapeutic protocols used
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Osteomyelitis The study by Esterhai
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Summary The HBO group showed a stat
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Summary These results are difficult
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outcomes or that decreased the risk
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Anderson et al 80 recruited non-pre
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Summary The collected evidence exam
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Table 46 Major outcomes following t
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Table 50 Therapeutic protocols used
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Table 53 Patient criteria of includ
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Thirty-seven subjects (comparison g
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whose hearing loss was not secondar
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tinnitus (6 versus 3 subjects). Non
Page 79 and 80: assume that all participants knew o
Page 81 and 82: Table 64 Therapeutic protocols used
Page 83 and 84: Table 65 Descriptive characteristic
Page 85 and 86: Table 68 Therapeutic protocols used
Page 87 and 88: These contrasted with the conclusio
Page 89 and 90: Table 73 Patient criteria of includ
Page 91 and 92: Summary There are conflicting resul
Page 93 and 94: Summary separate and previously-stu
Page 95 and 96: need to insulate patients from outs
Page 97 and 98: Reactive effects A reactive effect
Page 99 and 100: Cost of major amputation The hospit
Page 101 and 102: Sensitivity analysis Table 79 shows
Page 103 and 104: Table 80 Estimation of incremental
Page 105 and 106: Sensitivity analysis Table 83 shows
Page 107 and 108: Conclusions Safety Potential risks
Page 109 and 110: Recommendations MSAC recommended th
Page 111 and 112: Appendix B Supporting committee Sup
Page 113 and 114: Appendix C Studies included in this
Page 115 and 116: Necrotising soft tissue infections:
Page 117 and 118: Soft tissue injuries: crush injurie
Page 119 and 120: Cancer: cervix First Author and Yea
Page 121 and 122: Appendix D Studies excluded in this
Page 123 and 124: 2. Shandling AH, Ellestad MH, Hart
Page 125 and 126: 5. Woo TCS, Joseph D, Oxer H. Hyper
Page 127 and 128: 22. Kunkler PB, Boulis-Wassif S, Sh
Page 129: 45. Wiernik G, Perrins D. The radio
Page 133 and 134: Hence, the total operating costs of
Page 135 and 136: Appendix G Reviews received from ot
Page 137 and 138: Sechrist Industries -- Hyperbaric O
Page 139 and 140: References 1. Hampson N. Hyperbaric
Page 141 and 142: 31. L'Abbe K, Detsky A, O'Rourke K.
Page 143 and 144: 61. Perrins DJ. Influence of hyperb
Page 145 and 146: 89. DiSabato F, Giacovazzo M, Crist
Page 147: 117.Plenk HP. Hyperbaric radiation
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