A5V4d

Health economics
at 3.5%. The analysis calculated both the most expensive and the least costly model of each category
of thermometer in order to demonstrate the range of costs for each type and how the costs might
overlap depending on which model is chosen.
This economic assessment only includes the direct costs of purchase price and, where applicable, the
costs of consumables (e.g. disposable covers, sterilised alcohol-impregnated wipes and replacement
batteries). Cleaning, maintenance, repair, and calibration costs, although important, were not included
here owing to time constraints in collecting the data for the guideline. However, they are not
considered to have an important influence on the relative costs of each model compared with its
alternatives.
Device-specific costs were obtained from the MHRA. 27 The same assumptions were used as a basis
for the calculation of the costs as were used by Crawford et al. 85 Table 11.1 summarises the
assumptions used in the costing model.
Axilla measurements can be provided by electronic and chemical thermometers. Tympanic
measurements are by specialised infrared sensing thermometers only. Chemical thermometers
supplied by different companies use different chemicals. Some change permanently when the
temperature is raised (e.g. 3M Tempadot) and others change colour for only a short while when
placed in contact with a hot object and then return to the original colour (e.g. Insight Nextemp). Both
may be labelled single use, but the second type can be used again on the same patient (providing
that it is kept clean with alcohol wipes), and is considered to be a reusable model in this analysis.
The cost of staff time required to measure temperature using each type of thermometer was included
in the analysis. Each thermometer has an average time to reading, which gives a total number of
hours required to read the thermometer per year, which was then calculated up to the 10 year time
horizon used in the cost analysis. This average time to reading is based on best guesses and not on
empirical data. These times are indicative only since they exclude any time to locate the device, clean
the device or fit and remove probe covers. Also, it does not take into account that nurses may be
undertaking other tasks while waiting for a reading for thermometers where this may take more than a
few seconds. For some adhesive chemical thermometers (e.g. Insight Traxit), the time to reading
changed depending on whether it was a first measurement or subsequent measurement since the
thermometer was already in position and at the correct temperature. Therefore the average time per
patient episode was calculated to be 180 seconds plus 85 seconds (17 × 5) for the 18 measurements,
giving a total of 265 seconds.
Table 11.1 Assumptions used in the costing model
Contact/chemical Electronic
contact
Number purchased One per measurement
(1,550,000)
Consumables Alcohol wipes may be
required if single-patientuse
devices are used
Battery
replacement
One per unit
(450)
Compact contact
electronic
One per hospital
bed
(2205)
Infrared sensing
(tympanic)
One per unit
(450)
Probe covers Alcohol wipes Probe covers
No Yes Yes Yes
Replacement Each patient or each
measurement, depending
on the model
Approximate
readings per
inpatient episode
Inpatient episodes
per year
0% 10% per annum 0%
18 18 18 18
86,000 86,000 86,000 86,000
243