OBJECTIVES : Endoscope is widely used in surgery, especially for those tertiary hospitals with large demand for procedures in China. Ethylene oxide, formaldehyde and peroxide plasma are common low temperature sterilization types with big different sterilizing efficiency. This study is to evaluate the cost-benefit of these three types in endoscope sterilization.

METHODS : In the day operating room of one tertiary hospital, we analyzed the economic effects of using three types of low-temperature sterilization systems to reprocess endoscopes equipped with four sets of endoscopes, three operating staff. Parameters were estimated from published literature and investigation. Decision tree and one-factor sensitivity analysis were applied. Cost were separated into direct cost in system, equipment and occupational protection; indirect cost, consist of reduced productivity due to occupational asthma and expected health-care and death expenditure; intangible cost including repair expense of endoscope. Benefit is associated with total revenue of hospital considering turnaround when the time of surgery is within 1.25 hour, between 1.25 hour and 15 hours and over 15 hours among ethylene oxide, formaldehyde and peroxide plasma low temperature sterilization systems.

RESULTS : In one year, for procedure within 1.25 hour, earnings of peroxide plasma sterilization associated with more procedures is outweighed by increased cost of system compared with ethylene oxide and formaldehyde. The accumulated cost of ethylene oxide, formaldehyde and peroxide plasma sterilization is 2,618,948 CNY vs. 1,770,404 CNY vs. 3,684,874 CNY；the net benefit is -1,901,275 CNY vs. -131,033 CNY vs. 905,366 CNY. The sensitivity analysis showed that resulting cost saving was more sensitive if fee for per procedure is over 262.41 CNY.

CONCLUSIONS : Peroxide plasma system showed significantly cost-benefit for the procedure within 1.25hour and fee for per procedure over 262.41 CNY, compared with ethylene oxide and formaldehyde low sterilizing systems.