Cost-effectiveness of a central venous catheter care bundle


Autoria(s): Halton, Kate A.; Cook, David; Paterson, David L.; Safdar, Nasia; Graves, Nicholas
Data(s)

2010

Resumo

Background: A bundled approach to central venous catheter care is currently being promoted as an effective way of preventing catheter-related bloodstream infection (CR-BSI). Consumables used in the bundled approach are relatively inexpensive which may lead to the conclusion that the bundle is cost-effective. However, this fails to consider the nontrivial costs of the monitoring and education activities required to implement the bundle, or that alternative strategies are available to prevent CR-BSI. We evaluated the cost-effectiveness of a bundle to prevent CR-BSI in Australian intensive care patients. ---------- Methods and Findings: A Markov decision model was used to evaluate the cost-effectiveness of the bundle relative to remaining with current practice (a non-bundled approach to catheter care and uncoated catheters), or use of antimicrobial catheters. We assumed the bundle reduced relative risk of CR-BSI to 0.34. Given uncertainty about the cost of the bundle, threshold analyses were used to determine the maximum cost at which the bundle remained cost-effective relative to the other approaches to infection control. Sensitivity analyses explored how this threshold alters under different assumptions about the economic value placed on bed-days and health benefits gained by preventing infection. If clinicians are prepared to use antimicrobial catheters, the bundle is cost-effective if national 18-month implementation costs are below $1.1 million. If antimicrobial catheters are not an option the bundle must cost less than $4.3 million. If decision makers are only interested in obtaining cash-savings for the unit, and place no economic value on either the bed-days or the health benefits gained through preventing infection, these cost thresholds are reduced by two-thirds.---------- Conclusions: A catheter care bundle has the potential to be cost-effective in the Australian intensive care setting. Rather than anticipating cash-savings from this intervention, decision makers must be prepared to invest resources in infection control to see efficiency improvements.

Formato

application/pdf

Identificador

http://eprints.qut.edu.au/39078/

Publicador

Public Library of Science

Relação

http://eprints.qut.edu.au/39078/1/39078P.pdf

DOI:10.1371/journal.pone.0012815

Halton, Kate A., Cook, David, Paterson, David L., Safdar, Nasia, & Graves, Nicholas (2010) Cost-effectiveness of a central venous catheter care bundle. PLoS ONE, 5(9), e12815-e12825.

Direitos

Copyright 2010 Halton et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Fonte

Faculty of Health; Institute of Health and Biomedical Innovation; School of Public Health & Social Work

Palavras-Chave #111700 PUBLIC HEALTH AND HEALTH SERVICES
Tipo

Journal Article