Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

Operating costs
Staffing costs
Draft guidelines suggest that staffing of a hyperbaric facility ought to be a full time
equivalent hyperbaric physician, a full-time hyperbaric nurse, and a hyperbaric technician.
It may be that a hyperbaric facility will have a number of monoplace chambers and the
operating cost will be split between them. In the primary analysis, one monoplace
chamber per hyperbaric facility was assumed. The cost per treatment was modelled on
the basis of two and four chambers per facility.
The costs of a hyperbaric nurse per annum is estimated to be $43,638, the base salary of
a full-time specialist clinical nurse. The average cost of a medical technician is estimated
as $38,467 per annum (salary of technical officer level I lower end of range of $577.30
per week and technical officer level II upper end of range of $902.20 per week). In the
sensitivity analysis the impact on the cost per session and course of treatment of not
having a full-time technician per unit was examined. In discussion with experts it was the
view of some that units may operate with only a nurse trained to operate a chamber. It is
unlikely that a hyperbaric facility with only one monoplace chamber will employ two full
time staff assisting a full time physician.
The cost of a hyperbaric specialist physician is more difficult to estimate since there is no
reliable data on the time spent by a physician in the care of patients in a monoplace
hyperbaric unit. One approach is to assume that the doctor is paid a fee per session. The
current Medicare fee for a hyperbaric treatment is $190. However it is not clear that this
fee represents the true opportunity cost of a specialist’s time. It may include a payment
for the amortisation of capital and other overhead costs. Another approach is to use the
typical specialist consultation fee under Medicare. This is arguably a more accurate
estimate of the opportunity cost of time. A third possibility is to use the salary of
hyperbaric physician in a public hospital. This would allow for the time spent by the
director of a unit in addition to direct patient care. In the primary analysis it is assumed
that the average cost per patient of a hyperbaric specialist is the fee for an initial specialist
visit multiplied by the number of sessions. The cost of an initial specialist visit is $65.80. 9
The total staffing cost is estimated to be $145,273 p.a.
In sensitivity analysis, the scenario used was one where a hyperbaric nurse, doctor and
technician, is required per hyperbaric facility with 2 and 4 HBOT monoplace chambers.
The cost is modelled using a salary of $100,000, which is in the mid-range of salaries paid
to a specialist hyperbaric physician in Australia.
Overhead and maintenance costs
The overhead cost is expected to be 28% of operating (staffing) costs, based on the
mean indirect cost for non-admitted patient services (1997-98 outpatient services for 8
hospitals). It is assumed that the facility has spare capacity and the cost of space for the
monoplace unit is included in overhead costs. The maintenance cost per year is assumed
to be $5,000 (personal communication from applicant).
The total overhead costs of operating a monoplace unit is estimated to be $40,676 per
annum.
116 Hyperbaric oxygen therapy