A SURVEY-BASED STUDY ON BREAKAGE RATE AND SINGLE-USE BRONCHOSCOPY SUITABILITY DEPENDENT ON TYPE OF PROCEDURE

TOPIC: Procedures TYPE: Original Investigations PURPOSE: Recently, studies have shown that repair costs have a great impact on the procedure costs related to the use of reusable flexible bronchoscopes (RFBs). Therefore, we aimed to assess the correlation between breakage rate, procedure complexity, and procedures assessed to be suitable for single-use flexible bronchoscopes (SFBs). METHODS: A total of 445 respondents from Europe, Japan, and the USA answered the questionnaire between July 10, 2020, and August 12, 2020. The respondents were procurement and physicians performing bronchoscopies in the intensive care unit (ICU) and the bronchoscopy suite. The questionnaire concerned the repair rates of RFBs and which procedures they perceived as suitable for SFBs. Data were collected using the survey tool QuestionPro, and all respondents were anonymized. Procedure complexity was distributed between complex and simple (1-0) by Professor and cardiothoracic surgeon at a Danish University Hospital. Subsequently, we looked at the correlation between procedure breakage rates, procedures suitable for SFBs, and procedure complexity via ordinary least square regression analyses. RESULTS: The top three procedures associated with the highest breakage rates was endobronchial ultrasound (EBUS) transbronchial needle aspiration (TBNA), removal of foreign bodies, and TBNA. Further, the top three procedures most suitable for SFBs were secretion management, bronchial alveolar lavage, and bronchial examination. Procedure complexity was positively correlated (P<0.001) with breakage rate and negatively correlated (P<0.001) with SFB suitability. However, the breakage rate was positively correlated (P<0.001) with SFB suitability. CONCLUSIONS: We found that complex procedures are associated with high breakage rates. This is likely caused by various tools passing through the working channel of the bronchoscope. Further, the respondents regarded SFBs as particularly suitable for high breakage procedures. This indicates that new innovative SFBs, suitable for complex procedures, would be preferred to lower the cost of use, due to the elimination of repair costs. Respondents also perceived SFBs as more suitable for simpler procedures. CLINICAL IMPLICATIONS: Healthcare systems are globally forced to prioritize resource allocations due to aging populations, increases in medical costs, and generally increased treatment costs. This resource scarcity has subsequently led to the development of value-based healthcare and procurement, where new technologies must prove to bring a reasonable holistic value compared to the cost of the technology. Physicians and procurement recognize the value that SFB’s bring to complex procedures by reducing repair costs while also seeing their suitability for simple procedures. Therefore, we assume that as high-performance SFBs become available, they will quickly be adopted into practice for more complex procedures, to bring down the financial and organizational burden associated with the high breakage rates, along with the other attractive values that SFBs bring. DISCLOSURES: Employee relationship with Ambu A/S Please note: 3 years Added 04/27/2021 by Lotte Ockert, source=Web Response, value=Salary Employee relationship with Ambu A/S Please note: Current Added 05/03/2021 by Rasmus Russell, source=Web Response, value=Salary No relevant relationships by Helena Travis, source=Web Response