Cost effectiveness of dressing in the prevention of catheter-related infection in critically ill patients
Introduction: Catheter-related infection is a complication of high morbimortality. The aim was to perform a cost-effectiveness analysis of gauze and medical tape, transparent semi–permeable and chlorhexidine-impregnated dressings for short-term central venous catheter, within the Brazilian Public Healthcare System (Sistema Único de Saúde – SUS) scenario.
Methodology: a decision tree was elaborated in order to evaluate the cost-effectiveness of dressings in the prevention of catheter-related infection in critically ill patients. The outcome was the probability of catheter-related infections prevention. Moreover, only direct medical expenses were considered. Sensitivity analyses were performed to evaluate the model uncertainties.
Results: Chlorhexidine-impregnated dressing presented higher cost-effectiveness when the base case was analyzed (cost of US$ 655 per case prevented, 99% of effectiveness), in comparison to gauze and medical tape dressing (US$ 696, effectiveness of 96%). Dressing changes performed before the recommended period, treatment performed exclusively in inpatient units and high effectiveness of gauze and medical tape dressing were variables that interfered with the results. The probability of death has also demonstrated to have a major impact on cost-effectiveness.
Conclusion: In the context of a Brazilian public hospital, the chlorhexidine-impregnated dressing presented higher cost-effectiveness when compared to the gauze and medical tape dressing or the transparent semi-permeable dressing.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).