[Reuse of single-use catheters: a dilemma to be clarified]

This paper proposes a cost benefit approach in evaluating reuse of single-use catheters, introducing cost of disposal and the concept of financial risk. An estimation of relevant variable and fixed costs is discussed, according to conditions and prices presently existing in Northern Italy. A formal model is developed to compare alternative reuse and no-reuse strategies. Use of internal versus external (Service centers) sterilization is also briefly scrutinized. A short review of literature concerning reuse is aimed to place the issue in the proper framework, listing critical problems as far as safety, risks of rupture, identification and control procedures, legal responsibility, informed consent by the patient. The conclusion is proposed that reuse of Medium-to-High cost catheters is highly profitable from the economic standpoint, subject to the condition that stringent quality procedures and controls are implemented to assess reasonable safety on behalf of the patient. Further, size of potential savings and gain in number of procedures performed are likely to request at least some institutional attention. Last, pooling relevant risks among several institutions is a plausible way to lower costs and make reuse possible also to smaller centers. The model may be used for self-assessment purposes concerning reuse introduction; the actual estimate of risk is critical in evaluating results.