Volume 13, Number 6—June 2007
Economic Evaluation and Catheter-related Bloodstream Infections
|Intervention||Estimated absolute incremental benefits
||Estimated incremental cost||Cost/benefit ratio||Sensitivity analysis||Ref.|
|Incidence CR-BSI, %||Mortality incidence, %|
|Baseline: CHG-SSD catheter||Variable||Not stated||Not stated||27|
|MR catheter†||−0.7||0.009 QALYs (–0.009, 0.016)||–$83 ($109, –$205)||Cost saving||Robust|
|Baseline: standard catheter||3.30||–||$469||29|
|CHG-SSD catheter||−1.94||–||–$222||Cost saving||Robust|
|MR catheter||−2.79||–||–$314||Cost saving||Robust|
|Baseline: standard catheter||5.20||0.78||$710||30|
|CHG-SSD catheter||−2.20 (−1.2, −3.4)||−0.33 (−0.09, −0.78)||–$262 (–$91, –$522)||Cost saving||Robust|
|Baseline: less stringent asepsis||5.30||0.80||$676||26|
|Maximal sterile barriers||−2.49||−0.38||–$274||Cost saving||Robust|
|Baseline: Povidone-iodine skin preparation||3.1||0.46||$265||23|
|Chlorhexidine gluconate||−1.6 (−0.6, −2.5)||−0.23 (−0.07, −0.47)||–$134 (–$21, –$286)||Cost saving||Robust|
|Baseline: standard dressing||5.00||0.05||$514||24‡|
|Chlorhexidine dressing§||−2.63||−0.03||–$259||Cost saving||Robust|
|Baseline: glass TPN bottles||10.0||0.50||Not stated||25‡|
|TPN bags¶||−6.67||−0.33||Not stated||$28,326/life saved||Variable|
|Baseline: 5 d||–||0.92||$1,398||Not clear from source what reported cost-effectiveness ratios represented||28‡|
*All estimates have been adjusted to 2005 US dollars. Values in parentheses are 95% confidence intervals. CR-BSI, catheter-related bloodstream infections; mortality, CR-BSI attributable mortality; CHG-SSD, chlorhexidine gluconate/silver sulfadiazine; QALYs, quality-adjusted life year; MR, minocycline and rifampicin; TPN, total parenteral nutrition.
†Refers to results for an 8-d duration of catheterization; intervention was cost-saving for durations >8 d and could not be evaluated for <8 d.
‡Cost year for original analysis not stated; therefore, assumed 1 year before publication.
§Refers to results using baseline conservative assumptions of 5% CR-BSI incidence rate, 1% CR-BSI attributable mortality rate, and $8,000 incremental CR-BSI treatment cost.
¶Refers to results using baseline conservative assumptions of 10% CR-BSI incidence rate, 5% CR-BSI attributable mortality rate, and relative reduction in risk for CR-BSI of 0.33.
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