The hidden cost of colonoscopy including cost of reprocessing and infection rate: the implications for disposable colonoscopes

Multiple studies have documented a high rate of contaminated colonoscopes after reprocessing. Contaminated reusable colonoscopes may increase the risk of device-related patient infections. As disposable colonoscopes enter the market, they may play a role in infection prevention and may be cost-effective at some facilities or in high-risk patients. Using a micro-costing approach, this study found that the cost per colonoscopy including purchase, maintenance and reprocessing ranges from US$188.64 at high volume centres (3000 annual procedures) to US$501.16 at low volume centres (1000 annual procedures). Accordingly, per-procedure capital costs range from US$87.48 to US$262.45; repair costs range from US$68.77 to US$206.32; cleaning supplies and labour costs US$32.39 and infections requiring hospitalisation cost US$20.12 to US$46.52. As disposable colonoscopes enter the market, low volume centres are most likely to achieve cost savings. Determining if post-procedural infection rates differ with reusable vs disposable colonoscopes is needed. ### In more detail Each year more than 15 million colonoscopy procedures are performed in the USA and the number is increasing.1 Colonoscopy is generally thought to be safe; however, patients are sometimes hospitalised afterwards, due to infections that may have been transmitted via contaminated colonoscopes (MAUDE Adverse Event Report).2 3 Colonoscopy-related infections and complications have been reported in multiple studies, although at lower rates compared with endoscopic retrograde cholangiopancreatography (ERCP).1 4 5 Guideline revisions in response to endoscope-associated infections require healthcare institutions to invest more resources in the high-level disinfection process or conversion to sterilisation (Ofstead et al ).5,6 Despite colonoscopy being the highest volume GI procedure, the true cost and time associated with reusable colonoscopes are unknown. The purpose of this study was to explore real-world costs associated with …