Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-05-17T18:58:39.557Z Has data issue: false hasContentIssue false

COST ANALYSIS OF PERIPHERALLY INSERTED CENTRAL CATHETER IN PEDIATRIC PATIENTS

Published online by Cambridge University Press:  20 December 2017

Zhaoxin Dong
Affiliation:
Institute of Health Policy, Management and Evaluation
Bairbre L. Connolly
Affiliation:
Department of Diagnostic Imaging
Wendy J. Ungar
Affiliation:
Institute of Health Policy, Management and Evaluation Program of Child Health Evaluative Sciences
Peter C. Coyte
Affiliation:
Institute of Health Policy, Management and Evaluationpeter.coyte@utoronto.ca

Abstract

Purpose: A peripherally inserted central catheter (PICC) is a useful option in providing secure venous access, which enables patients to be discharged earlier with the provision of home care. The objective was to identify the costs associated with having a PICC from a societal perspective, and to identify factors that are associated with total PICC costs.

Methods: Data were obtained from a retrospective cohort of 469 hospitalized pediatric patients with PICCs inserted. Both direct and indirect costs were estimated from a societal perspective. Insertion costs, complication costs, nurse and physician assessment costs, inpatient ward costs, catheter removal costs, home care costs, travel costs, and the cost associated with productivity losses incurred by parents were included in this study.

Results: Based on catheter dwell time, the median total cost associated with a PICC per patient per day (including inpatient hospital costs) was $3,133.5 ($2,210.7–$9,627.0) in 2017 Canadian dollars ($1.00USD = $1.25CAD in 2017). The adjusted mean cost per patient per day was $2,648.2 ($2,402.4–$2,920.4). Excluding inpatient ward costs, the median total and adjusted costs per patient per day were $198.8 ($91.8–$2,475.8) and $362.7($341.0–$386.0), respectively. Younger age, occurrence of complications, more catheter dwell days, wards with more intensive care, and the absence of home care were significant factors associated with higher total PICC costs.

Conclusions: This study has demonstrated the costs associated with PICCs. This information may be helpful for healthcare providers to understand PICC related cost in children and resource implications.

Type
Assessments
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Cheung, E, Baerlocher, M, Asch, M, et al. Venous access: A practical review for 2009. Can Fam Physician. 2009;55:494-496.Google Scholar
2. Polak, J, Anderson, D, Hagspiel, K, et al. Peripherally inserted central venous catheters: Factors affecting patient satisfaction. AJR Am J Roentgenol. 1998;170:1609-1611.CrossRefGoogle ScholarPubMed
3. Schwengel, D, McGready, J, Berenholtz, S, et al. Peripherally inserted central catheters: A randomized, controlled, prospective trial in pediatric surgical patients. Anesth Analg. 2004;99:1038-1043.CrossRefGoogle ScholarPubMed
4. Smith, J, Friedell, M, Cheatham, M, et al. Peripherally inserted central catheters revisited. Am J Surg. 1998;176:208-211.Google Scholar
5. O'Grady, NP, Alexander, M, Burns, LA, et al. Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52:e162-e193.Google Scholar
6. Keeler, M. Cost-effectiveness analysis of tunneled central venous catheter dressings in Canadian blood stem cell transplant (2014). Nursing theses and dissertations. Paper 19. http://hdl.handle.net/10950/205 (accessed November 22, 2017).Google Scholar
7. Raschka, S, Dempster, L, Bryce, E. Health economic evaluation of an infection prevention and control program: Are quality and patient safety programs worth the investment? Am J Infect Control. 2013;41:773-777.Google Scholar
8. Di Carlo, I, Biffi, R. Total implantable venous access devices. New York: Springer; 2012:259-262. Google Scholar
9. Haider, G, Kumar, S, Salam, B, et al. Determination of complication rate of PICC lines in oncological patients. J Pak Med Assoc. 2009;59:663-667.Google Scholar
10. Periard, D, Monney, P, Waeber, G, et al. Randomized controlled trial of peripherally inserted central catheters vs. peripheral catheters for middle duration in-hospital intravenous therapy. J Thromb Haemost. 2008;61281-1288.Google Scholar
11. Drummond, M, Sculpher, M, Torrance, G, et al. Methods for the economic evaluation of health care programmes. 3rd ed. Chapter 2. Basic types of economic evaluation. Oxford: Oxford University Press; 2005:19.Google Scholar
12. Van Winkle, P, Whiffen, T, Liu, I. Experience using peripherally inserted central venous catheters for outpatient parenteral antibiotic therapy in children at a community hospital. Pediatr Infect Dis J. 2008;27:1069-1072.Google Scholar
13. Thiagarajan, R, Ramammoorthy, C, Gettmann, T, et al. Survey of the use of peripherally inserted central venous catheters in children. Pediatrics. 1997;99:e4.Google Scholar
14. Moore, JA, Wei, JL, Smith, HJ, et al. Treatment of pediatric suppurative mastoiditis: Is peripherally inserted central catheter (PICC) antibiotic therapy necessary? Otolaryngol Head Neck Surg. 2006;135:106-110.Google Scholar
15. Statistics Canada. Consumer Price Index, health and personal care, by province. http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/econ161a-eng.htm (accessed November 22, 2017).Google Scholar
16. Ontario Health Insurance (OHIP) Schedule of Benefits and Fees. http://www.health.gov.on.ca/english/providers/program/ohip/sob/sob_mn.html (accessed November 22, 2017).Google Scholar
17. Hancock-Howard, R, Connolly, BL, McMahon, M, et al. Cost-effectiveness analysis of implantable venous access device insertion using interventional radiologic versus conventional operating room methods in pediatric patients with cancer. J Vasc Interv Radiol. 2010;21:677-684.CrossRefGoogle ScholarPubMed
18. Guerriere, D, Zagorski, B, Fassbender, K, et al. Cost and variations in ambulatory and home based palliative care. Palliat Med. 2010;24:523-532.Google Scholar
19. Ungar, WJ. Economic evaluation in child health, OUP 2010. In: Ungar, WJ, Gerber, A, eds. The uniqueness of child health and challenges to measuring costs and consequences. Oxford: Oxford University Press Online.CrossRefGoogle Scholar
20. Liljas, B. How to calculate indirect costs in economic evaluations. Pharmacoeconomics. 1998;13:1-7.Google Scholar
21. Statistics Canada. Average hourly wages of employees by selected characteristics and occupation, unadjusted data, by province (monthly) (Ontario). http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/labr69g-eng.htm (accessed November 22, 2017).Google Scholar
22. Andersen, R, Newman, J. Societal and individual determinants of medical care utilization in the United States. Millbank Mem Fund Q Health Soc. 1973;51:95-124.Google Scholar
23. Manning, WG. The logged dependent variable, heteroscedasticity, and the retransformation problem. J Health Econ. 1998;17:283-295.Google Scholar
24. Canadian Agency for Drugs and Technologies in Health. Guidelines for the economic evaluation of health technologies: Canada. 3rd ed. Ottawa: Canadian Agency for Drugs and Technologies in Health; 2006.Google Scholar
25. Murphy, G, Spry, C. (2008). Peripherally inserted central catheter (PICC) stabilization devices: Clinical and cost-effectiveness and guidelines for use. Health Technology Inquiry Service report. http://www.cadth.ca/media/pdf/htis/Peripherally%20Inserted%20Central%20Catheter%20(PICC)%20Stabilization%20Devices%20Clinical%20and%20Cost-Effectiveness.pdf (accessed November 22, 2017).Google Scholar
26. Eng, J. Sample size estimation: How many individuals should be studied. Radiology. 2003;227:309-313.CrossRefGoogle ScholarPubMed
Supplementary material: File

Dong et al supplementary material

Tables S1 and S2

Download Dong et al supplementary material(File)
File 52.6 KB