title: An economic model to assess the cost and benefits of the routine use of silver alloy coated urinary catheters to reduce the risk of urinary tract infections in catheterized patients.
abstract: Prevalence studies generally find nosocomial urinary tract infections to be the most common type of nosocomial infection, accounting for between 21% and 45% of all HAIs. The main risk factor appears to be the presence of a urinary catheter, with an estimated 80% of these infections being associated with their use. This paper describes a model which quantifies the extent of the burden of these infections in terms of the number of patients affected and the costs incurred by the hospital sector; and identifies the potential benefits of the routine use of silver alloy coated catheters, as a means of reducing the incidence of this type of infection. An illustrative model of the annual costs and benefits associated with the routine use of this intervention in adult, non-day case patients admitted to the medical and surgical specialties of NHS hospitals throughout England is presented. The results suggest that a 14.6% reduction in the incidence of urinary tract infections in catheterized medical patients, and a 11.4% reduction in catheterized surgical patients, would cover the cost of the intervention. Any further reduction in incidence would result in net positive benefits.
authors.affiliation: London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. R.Plowman@lshtm.ac.uk
authors.forename: R
authors.initials: R
authors.lastname: Plowman
authors.forename: N
authors.initials: N
authors.lastname: Graves
authors.forename: J
authors.initials: J
authors.lastname: Esquivel
authors.forename: J A
authors.initials: JA
authors.lastname: Roberts
mesh_terms: D000328:Adult; D000497:Alloys / Q000191:economics* / Q000592:standards*; D002408:Catheters, Indwelling / Q000191:economics* / Q000592:standards*; D020099:Coated Materials, Biocompatible / Q000191:economics* / Q000592:standards*; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000191:economics* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004739:England / Q000453:epidemiology; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000191:economics / Q000379:methods; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D017059:Models, Econometric; D010343:Patient Admission / Q000191:economics / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012834:Silver / Q000191:economics* / Q000592:standards*; D013222:State Medicine; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000295:instrumentation*; D014552:Urinary Tract Infections / Q000191:economics* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000497:Alloys; D020099:Coated Materials, Biocompatible; D012834:Silver