[Cost-benefit analysis of a new treatment concept in patients with indwelling catheters]

An earlier and a new treatment concept for patients equipped with long-term indwelling bladder catheters were compared with regard to cost, expenditure of time, and equipment in a retrospective study involving 58 patients treated by the earlier concept and 60 treated by the new one. The new concept dispensed with the need for bladder irrigation and routine replacement of the indwelling catheters. Under the earlier concept, 18 indwelling catheter replacements and 53 bladder irrigations were required per patient and year during the years 1979/80. This compares with 6 indwelling catheter replacements and 0.05 bladder irrigations per patient and year for the years 1989/90 under the new concept. The use of analgesics and spasmolytics fell from 55 to 21 units per patient per year. Significantly fewer urinalyses were performed during 1989/90. The use of antibiotics remained unchanged. When compared with the earlier one, the new concept for the management of patients with indwelling catheters provides savings of 1265 minutes (21 hours) of nursing time and sFr. 405 for equipment per patient per year. Applied to our geriatric hospital (120 beds, 80 nursing staff), this translates into annual savings of one full nursing post and sFr. 34,000 for equipment.