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Bedside placement of peripherally inserted central catheters: a cost-effectiveness analysis
M L Neuman1, B D Murphy, M P Rosen
1Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Radiology
|February 11, 1998
Summary
Strategy A, with bedside placement by nurses, is more cost-effective for peripherally inserted central catheters (PICCs) if imaging costs exceed $100. Strategy B, with radiologist-led placement, is better if imaging costs are below $75.
Area of Science:
- Medical Devices
- Interventional Radiology
- Health Economics
Background:
- Peripherally inserted central catheters (PICCs) are crucial for long-term intravenous access.
- Current placement strategies vary, impacting cost-effectiveness and patient outcomes.
- Optimizing PICC insertion protocols is essential for efficient healthcare delivery.
Purpose of the Study:
- To compare the cost-effectiveness of two distinct PICC placement strategies.
- Strategy A: Bedside placement by trained nurses with radiology backup for failures.
- Strategy B: Exclusive placement by interventional radiologists using imaging guidance.
Main Methods:
- Decision analysis and cost-effectiveness modeling were employed.
- Data synthesized from institutional experience and existing literature.
- Models evaluated economic viability based on varying cost parameters.
Main Results:
- The relative cost-effectiveness of Strategy A versus Strategy B is contingent upon.
- Factors include the success rate of bedside i.v. team insertions.
- The cost of fluoroscopy/interventional radiology suite usage, and the intended clinical application of the PICC.
Conclusions:
- Strategy A is more cost-effective when fluoroscopy/IR suite costs surpass $100.
- Strategy B is more cost-effective for all uses if imaging costs are below $75.
- For imaging costs between $75-$100, the optimal strategy depends on specific clinical needs and tip placement precision requirements.