Cost-effectiveness of a central venous catheter care bundle.

<h4>Background</h4>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 t...

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Autores principales:	Kate A Halton, David Cook, David L Paterson, Nasia Safdar, Nicholas Graves
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2010
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7e27871942c440f0be69cc9649024662
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spelling	oai:doaj.org-article:7e27871942c440f0be69cc96490246622021-11-18T06:35:05ZCost-effectiveness of a central venous catheter care bundle.1932-620310.1371/journal.pone.0012815https://doaj.org/article/7e27871942c440f0be69cc96490246622010-09-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20862246/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods and findings</h4>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.<h4>Conclusions</h4>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.Kate A HaltonDavid CookDavid L PatersonNasia SafdarNicholas GravesPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 5, Iss 9 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kate A Halton David Cook David L Paterson Nasia Safdar Nicholas Graves Cost-effectiveness of a central venous catheter care bundle.
description	<h4>Background</h4>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.<h4>Methods and findings</h4>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.<h4>Conclusions</h4>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.
format	article
author	Kate A Halton David Cook David L Paterson Nasia Safdar Nicholas Graves
author_facet	Kate A Halton David Cook David L Paterson Nasia Safdar Nicholas Graves
author_sort	Kate A Halton
title	Cost-effectiveness of a central venous catheter care bundle.
title_short	Cost-effectiveness of a central venous catheter care bundle.
title_full	Cost-effectiveness of a central venous catheter care bundle.
title_fullStr	Cost-effectiveness of a central venous catheter care bundle.
title_full_unstemmed	Cost-effectiveness of a central venous catheter care bundle.
title_sort	cost-effectiveness of a central venous catheter care bundle.
publisher	Public Library of Science (PLoS)
publishDate	2010
url	https://doaj.org/article/7e27871942c440f0be69cc9649024662
work_keys_str_mv	AT kateahalton costeffectivenessofacentralvenouscathetercarebundle AT davidcook costeffectivenessofacentralvenouscathetercarebundle AT davidlpaterson costeffectivenessofacentralvenouscathetercarebundle AT nasiasafdar costeffectivenessofacentralvenouscathetercarebundle AT nicholasgraves costeffectivenessofacentralvenouscathetercarebundle
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Cost-effectiveness of a central venous catheter care bundle.

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