Cost analysis
weakness, hypothermia, chills
COMPLICATIONS
From the perspective of a hospital, besides OR efficiency, whether aggressive warming is cost-effective also depends on the costs of thermal management and the value of each minute of OR time saved.The primary cost of aggressive warming originates from the FAW, which is the most commonly used and effective device to prevent perioperative hypothermia (The value of each minute of OR time was difficult to estimate and was affected by local costs and policies (At present, hospitals in low-income and middle-income countries will face enormous financial pressure to take the initiative to provide aggressive warming, which ultimately leads to the difficulty of the wide use of aggressive warming and loss of thermal comfort for patients. We suggest health policies should be considered from the perspective of both patients and hospitals to encourage hospitals to provide better medical service. Under the current price system in China, compared to aggressive warming to 37°C, keeping intraoperative temperature at least 35.5°C might be equally safe and more economic. Aggressive warming can be used according to patient wishes.In fact, availability and affordability to medical therapies remains one of the biggest health challenges faced by developing countries. The national volume-based procurement (NVBP) was launched in China aiming to reduce drug prices and improve the affordability of medicines and medical consumables (Our study had some limitations. First, the OR efficiency was analyzed based on the operating room regulation that no procedure could be performed after 18: 00 in our analysis, which would restrict the number of operations. Second, in some hospitals, extubation was achieved in the PACU, where reduced recovery time may not directly influence the OR efficiency or could cause decreased economic benefit because fewer staff members were affected, and this was not applicable to our study.An additional limitation is that we did not assess the thermal comfort of patients using different thermal management strategies. Complications due to hypothermia, such as chills and feelings of weakness, can cause discomfort and uneasiness for patients but may have a slight effect on cost analysis.However, our study provides a calculation method for the cost analysis of aggressive warming. The parameters in our analysis can be adjusted according to the reality of other hospitals or regions.