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Table 1 Unit costs for total hip and knee replacement resource use

From: Local anaesthetic wound infiltration in addition to standard anaesthetic regimen in total hip and knee replacement: long-term cost-effectiveness analyses alongside the APEX randomised controlled trials

Resource use Unit cost Assumption Source
Initial inpatient admission
Theatre (per minute) £14.22 Includes implant cost, staff time, overheads, consumables, facilities North Bristol NHS Trust Finance department
Injection of local anaesthesia infiltration (LAI) £2.00 Box of bupivicaine with adrenaline 0.25 %/1 in 200,000 is £20.00; one box contains 10 ampoules North Bristol NHS Trust Finance department, management, and procurement
Recovery (per minute) £3.84 Includes staff time with overheads, consumables, facilities, and medications administered during stay; base cost per minute North Bristol NHS Trust Finance department
Day in general orthopaedics ward: Frome, Severn, Kennett, and Cardiac Care Unit £311 Includes staff time with overheads, consumables, facilities, and medications administered during stay; base cost per day North Bristol NHS Trust Finance department
Day in other orthopaedics ward: Chew £250 Includes staff time with overheads, consumables, facilities, and medications administered during stay; base cost per day North Bristol NHS Trust Finance department
Day in high dependency unit £1,356 Includes staff time with overheads, consumables, facilities, and medications administered during stay; base cost per day North Bristol NHS Trust Finance department
Inpatient admissions following discharge from initial surgery
Revision surgery – Total knee replacement (TKR) £9,439 HB22A major knee procedures for non-trauma, with major comorbidity and complication (CC) NHS Reference Costs 2012–2013: Non-elective long stay
Revision surgery – Total hip replacement (THR) £8,890 HB12A major hip procedures for non-trauma, with major CC NHS Reference Costs 2012–2013: Non-elective long stay
Manipulation under anaesthetic – TKR £2,044 HB24C minor knee procedures for non-trauma, category 2, without CC NHS Reference Costs 2012–2013: Non-elective long stay
Infections £4,124 Infections of bones or joints, with CC Score 5–8 NHS Reference Costs 2012–2013: Non-elective long stay
Day case procedures – TKR £655 Day case: HB29Z minimal knee procedures for non-trauma NHS Reference Costs 2012–2013: Non-elective day case
Day case procedures – THR £788 Day case: HB19Z minimal hip procedures for non-trauma NHS Reference Costs 2012–2013: Non-elective day case
Nights in hospital for other admissions a £311 Unit cost based on SMH cost per night in general orthopaedics ward North Bristol NHS Trust Finance department
A and E and outpatient visits
Accident and emergency £117 Average of all accident and emergency visits NHS Reference Costs 2012–2013: Outpatient appointments: 180 Accident & Emergency
Trauma and orthopaedics – consultant led £102 Non-admitted face to face attendance, follow-up, consultant led NHS Reference Costs 2012–2013: Outpatient appointments: 110 Trauma & Orthopaedics
Trauma and orthopaedics – non-consultant led £90 Non-admitted face to face attendance, follow-up, non-consultant led NHS Reference Costs 2012–2013: Outpatient appointments: 110 Trauma & Orthopaedics
Physiotherapy – non-consultant led £39 Non-admitted face to face attendance, follow-up, non-consultant led NHS Reference Costs 2012–2013: Outpatient appointments: 650 Physiotherapy
General Medicine – consultant led £145 Non-admitted face to face attendance, follow-up, consultant led NHS Reference Costs 2012–2013: Outpatient appointments: 300 General Medicine
Neurology – consultant led £157 Non-admitted face to face attendance, follow-up, consultant led NHS Reference Costs 2012–2013: Outpatient appointments: 400 Neurology
Respiratory – consultant led £137 Non-admitted face to face attendance, first appointment, consultant led NHS Reference Costs 2012–2013: Outpatient appointments: 340 Respiratory Medicine
Pain management – consultant led £136 Non-admitted face to face attendance, follow-up, consultant led NHS Reference Costs 2012–2013: Outpatient appointments: 191 Pain management
Vascular – consultant led £133 Non-admitted face to face attendance, follow-up, consultant led NHS Reference Costs 2012–2013: Outpatient appointments: 107 Vascular surgery
Dermatology – consultant led £95 Non-admitted face to face attendance, follow-up, consultant led NHS Reference Costs 2012–2013: Outpatient appointments: 330 Dermatology
Haematology – consultant led £209 Non-admitted face to face attendance, follow-up, consultant led NHS Reference Costs 2012–2013: Outpatient appointments: 303 Clinical Haematology
Community based health services
GP surgery visit £45 Base cost per patient contact with GP with qualifications, including direct care staff costs, lasting 11.7 min Personal Social Services Research Unit (PSSRU) 2013: 10.8b General practitioner
GP home visit £114 Base cost per out of surgery visit with GP with qualifications, including direct care staff costs, lasting 23.4 min PSSRU 2013: 10.8b General practitioner
Phoned GP for advice £27 Base cost per telephone consultation with GP with qualifications, including direct care staff costs, lasting 7.1 min PSSRU 2013: 10.8b General practitioner
GP Practice nurse visit £13.43 Based on 15.5 min per surgery consultation using the base cost (£52) of one hour of face-to-face contact with GP nurse with qualifications PSSRU 2013: 10.6 Nurse (GP practice)
Phoned GP practice nurse for advice £4 Based on 6 min of GP nurse time using the base cost (£40) of 1 hour of GP nurse time with qualifications PSSRU 2013: 10.6 Nurse (GP practice)
Repeat prescription (without seeing doctor) £11.40 Based on 3 min of GP time, using the base cost of 1 minute GP patient contact time (£3.80), with qualifications, including direct care staff costs PSSRU 2013: 10.8b General practitioner
District nurse £18.08 Based on the assumption that the duration of a district nurse visit is the same as GP nurse visit (15.5 min) and using the base cost of 1 hour of community nurse visit (£70) with qualifications including travel PSSRU 2013: 10.1 Community nurse
Occupational therapist at home/GP surgery/clinic £17 Based on 30 min contact using the base cost (£34) of 1 hour of occupational therapist contact with qualifications PSSRU 2013: 9.2 NHS community occupational therapist
Community physiotherapist at home/GP surgery/clinic £17 Based on 30 min contact using the base cost (£34) of 1 hour of physiotherapist contact with qualifications PSSRU 2013: 9.1 Community physiotherapist
Prescriptions costs per consultation £44.64 Prescription costs per consultation (net ingredient cost) PSSRU 2013:10.8b General practitioner
Social services
Home care worker (home help) provided by social services £24 Based on 1 hour of face-to-face weekday contact for independent sector home care provided for social services PSSRU 2013: 11.6
Food at home service (meals on wheels) £3.14 Based on one meal a day using the Meals on Wheels average weekly cost (2012/2013) of £44, assuming two meals per day, 7 days a week PSSRU 2013: 8.1.1 Community care package for older people: very low cost
Social worker visits £113 Based on a 30 min visit using the base cost (£226) of 1 hour of face-to-face contact of social worker with qualifications PSSRU 2013: 11.2 Social worker (adult services)
Social worker telephone calls £39.50 Based on a 30 min telephone call using a base cost (£79) of 1 hour of client-related work of a social worker with qualifications PSSRU 2013: 11.2 Social worker (adult services)
Home changes and equipment provided by social services:   All unit costs for home changes and equipment are based on 3-month loan period, assuming a 24 months life span  
Toilet seat or toilet raiser £1.80 Cost of equipment £14 NRS price – equipment provider for North Bristol NHS Trust
Dressing aids: socks, shoes, etc. £1.25 Cost of equipment £10 NRS price – equipment provider for North Bristol NHS Trust
Furniture raisers £2.48 Cost of equipment £20 NRS price – equipment provider for North Bristol NHS Trust
Perching stool £6.00 Cost of equipment £48 NRS price – equipment provider for North Bristol NHS Trust
Walker or trolley £7.50 Cost of equipment £60 NRS price – equipment provider for North Bristol NHS Trust
Crutches £3.75 Cost of equipment £30 NRS price – equipment provider for North Bristol NHS Trust
Commode £5.69 Cost of equipment £46 NRS price – equipment provider for North Bristol NHS Trust
Rails and hand grips £2.85 Cost of equipment £23 NRS price – equipment provider for North Bristol NHS Trust
Bath boards £3.00 Cost of equipment £24 NRS price – equipment provider for North Bristol NHS Trust
Hospital bed at home £59.88 Cost of equipment £479 Online search for procurement prices (cheaper range)
Bath lift £44.75 Cost of equipment £358 Online search for procurement prices (cheaper range)
Chair and stair lift £125.00 Cost of equipment £1000 Online search for procurement prices (cheaper range)
  1. a When healthcare resource group codes could not be derived because of insufficient information, inpatient admissions were valued multiplying the number of nights admitted to a ward by the cost of a night in a general orthopaedics ward provided by the North Bristol Trust finance department