Cost analysis of different medical oxygen sources for a healthcare facility in India

Varun Manhas; Mahipal Rawat; Yogesh S Kaurav; Sanjay Goyal; Sanjay Dhir; Kalyani Sangineni

doi:10.4103/ija.ija_335_23

Cost analysis of different medical oxygen sources for a healthcare facility in India

Indian J Anaesth. 2024 Apr;68(4):374-379. doi: 10.4103/ija.ija_335_23. Epub 2024 Mar 13.

Authors

Varun Manhas¹, Mahipal Rawat², Yogesh S Kaurav³, Sanjay Goyal⁴, Sanjay Dhir⁵, Kalyani Sangineni⁶

Affiliations

¹ One Health Trust, Bengaluru, Karnataka, India.
² Independent Consultant, Satpura Bhawan, Bhopal, Madhya Pradesh, India.
³ Directorate Health Services, Satpura Bhawan, Bhopal, Madhya Pradesh, India.
⁴ Revenue Department, Government of Madhya Pradesh, Bhopal, Madhya Pradesh, India.
⁵ Department of Management Studies (DMS), Indian Institute of Technology (IIT), New Delhi, India.
⁶ Department of Anaesthesia, All India Institute of Medical Sciences (AIIMS), Bibinagar, Telangana, India.

Abstract

Background and aims: Multiple sources of medical oxygen, namely liquid medical oxygen (LMO) tanks, pressure swing adsorption (PSA) plants, concentrators, and gaseous cylinders, are available at different healthcare facilities. These sources of oxygen have varying installation and operational costs. In low-resource settings, it is imperative to utilise these assets optimally. This study investigated the operational costs of multiple oxygen sources available at a healthcare facility.

Methods: A Microsoft (MS) Excel-based model was developed to analyse and compare the oxygen manufacturing costs (in ₹/m³) using PSA plants and procurement costs (in ₹/m³) of LMO and third-party vendor-refilled cylinders.

Results: The oxygen manufacturing costs for PSA plants of different capacities and running times on electricity and diesel generators (DGs) as a power source were calculated. This study highlights the cost-benefit of using PSA plants over LMO and third-party vendor-refilled cylinders as a source of oxygen. PSA plants are most economical when they are of higher capacity and used to their maximum capacity on electricity as the power source. On the contrary, they are most expensive when used on a DG set as a power source. Furthermore, this study provides evidence of PSA plants being more cost-effective for refilling cylinders using a booster compressor unit when compared to third-party vendor-cylinder refilling.

Conclusion: Given their cost-effectiveness and low third-party dependence, they should be utilised to their maximum capacity as medical oxygen sources at healthcare facilities.

Keywords: Booster compressor units; cost analysis; gaseous cylinders; hospitals; liquid medical oxygen; medical oxygen; pressure swing adsorption plants.