Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model.
Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model.
- 2022
CONCLUSION: In this study comparing the labor costs of two approaches for CVC confirmation, the more efficient alternative (POCUS-guided) is not more expensive than traditional CXR. Performing an economic analysis framed in terms of labor costs and work efficiency may influence stakeholders and facilitate earlier adoption of POCUS for CVC confirmation. INTRODUCTION: Despite evidence suggesting that point-of-care ultrasound (POCUS) is faster and non-inferior for confirming position and excluding pneumothorax after central venous catheter (CVC) placement compared to traditional radiography, millions of chest radiographs (CXR) are performed annually for this purpose. Whether the use of POCUS results in cost savings compared to CXR is less clear but could represent a relative advantage in implementation efforts. Our objective in this study was to evaluate the labor cost difference for POCUS-guided vs CXR-guided CVC position confirmation practices. METHODS: We developed a model to evaluate the per patient difference in labor cost between POCUS-guided vs CXR-guided CVC confirmation at our local urban, tertiary academic institution. We used internal cost data from our institution to populate the variables in our model. 82 (21%) per patient using POCUS for CVC confirmation. RESULTS: The estimated labor cost per patient was
English
1936-900X
10.5811/westjem.2022.7.56501 [doi] PMC9541994 [pmc] westjem.2022.7.56501 [pii]
*Catheterization, Central Venous
*Central Venous Catheters
Catheterization, Central Venous/mt [Methods]
Cost-Benefit Analysis
Critical Illness
Humans
Prospective Studies
Radiography
Radiography, Thoracic
Ultrasonography, Interventional
MedStar Health Research Institute
Journal Article
CONCLUSION: In this study comparing the labor costs of two approaches for CVC confirmation, the more efficient alternative (POCUS-guided) is not more expensive than traditional CXR. Performing an economic analysis framed in terms of labor costs and work efficiency may influence stakeholders and facilitate earlier adoption of POCUS for CVC confirmation. INTRODUCTION: Despite evidence suggesting that point-of-care ultrasound (POCUS) is faster and non-inferior for confirming position and excluding pneumothorax after central venous catheter (CVC) placement compared to traditional radiography, millions of chest radiographs (CXR) are performed annually for this purpose. Whether the use of POCUS results in cost savings compared to CXR is less clear but could represent a relative advantage in implementation efforts. Our objective in this study was to evaluate the labor cost difference for POCUS-guided vs CXR-guided CVC position confirmation practices. METHODS: We developed a model to evaluate the per patient difference in labor cost between POCUS-guided vs CXR-guided CVC confirmation at our local urban, tertiary academic institution. We used internal cost data from our institution to populate the variables in our model. 82 (21%) per patient using POCUS for CVC confirmation. RESULTS: The estimated labor cost per patient was
English
1936-900X
10.5811/westjem.2022.7.56501 [doi] PMC9541994 [pmc] westjem.2022.7.56501 [pii]
*Catheterization, Central Venous
*Central Venous Catheters
Catheterization, Central Venous/mt [Methods]
Cost-Benefit Analysis
Critical Illness
Humans
Prospective Studies
Radiography
Radiography, Thoracic
Ultrasonography, Interventional
MedStar Health Research Institute
Journal Article