Study objectives: Information regarding intravenous patient-controlled analgesia (IV PCA) resource utilisation, hospital logistics and costs is limited.  This multicentre study, conducted in France, Germany and the UK, examined these aspects of IV PCA treatment between Mar 2004 and Apr 2005.
Methods: Information about IV PCA-related staff time and resource use were recorded for patients (n = 315) who had undergone elective orthopaedic or abdominal surgery.  The nature and severity of IV PCA-related complications (e.g. problems with drugs or pumps) were also recorded.  The unit cost of each staff member and resources used for an episode of IV PCA therapy were derived from national and local sources.  The sum of staff members and resource costs associated with IV PCA treatment was calculated in order to generate a per-patient cost estimate of an IV PCA episode.

Results: An episode of IV PCA therapy lasted a mean of 1.6 days and had a mean cost of Euro 96.40.  Costs were attributed to staff time (78%), pump costs (11%) and consumable costs (11%).  The mean time spent on IV PCA-related tasks by all hospital staff in the recovery room was 24.2 minutes (nurses, 20.4 minutes), with 47.1 minutes spent by all staff in the ward (nurses, 39.3 minutes).  The most frequently occurring IV PCA-related incidents that required staff attention were patient-related (0.8 incidents per patient) and drug-related (0.7 incidents per patient) problems.  The most costly IV PCA incidents were drug-related (Euro 9.10 per incident) and pump-related (Euro 8.70 per incident).

Conclusions: Substantial staff time and costs are associated with IV PCA treatment.