OBJECTIVES: Inadvertent perioperative hypothermia is a well-known and relatively common occurrence, which can negatively affect patients’ surgery outcome, lengthening their stay in hospital and treatment costs. Nevertheless, it may be prevented with proactive body temperature management strategies as those recommended by international guidelines and, with specific reference to the Italian context, the Good Clinical Practice (GCP) by the Italian Society of Anesthesia, Analgesia, Reanimation and Intensive Care (SIAARTI). This study aimed to conduct a budget impact analysis (BIA) of the implementation and spread of the recommended strategies to maintain euthermia in surgical patients in Italy, assuming the National Health Service perspective.

METHODS: the BIA of implementing the protocol for monitoring and maintaining perioperative normothermia in Italy over a three-year period was performed as the comparison between a scenario where this procedure was introduced and a scenario without its adoption, considering direct medical costs (year 2019). Both Italian and international sources were taken into account for the model inputs. A decision tree model was used to estimate the impact of various clinical strategies to prevent hypothermia on the incidence of each adverse health consequences.

RESULTS: The implementation of the protocol entailed additional costs due to the greater use of forced-air warming systems and inductive heating mattresses and blankets. However, there was a reduction in the costs of managing hypothermia-related adverse events. The overall BIA showed net savings of almost 60.92 million euros in the third year implementing the protocol. Besides, the sensitivity analysis showed a higher sensitivity of the net benefit to the cost of hospitalization and the incidence of inadvertent perioperative hypothermia.

CONCLUSIONS: The introduction and diffusion of perioperative normothermia best-practices within the Italian National Health Service would lead to substantial savings in addition to the proven clinical advantages.