title: Economic impact of use of chlorhexidine-impregnated sponge dressing for prevention of central line-associated infections in the United States.
abstract: BACKGROUND
  The economic impact of adding chlorhexidine gluconate (CHG)-impregnated sponge dressing to standard care (ie, chg-impregnated sponge dressing + skin preparation and transparent film dressing vs skin preparation and transparent film dressing) for the prevention of central-line infections was evaluated.
  
  
  METHODS
  Clinical and economic data were obtained from peer-reviewed published studies to populate the decision model. The efficacy of reducing catheter-related bloodstream infection (CR-BSI) incidence with CHG-impregnated sponge dressing came from 2 recent randomized controlled trials. One-way and two-way sensitivity analyses were performed on key clinical and economic parameters.
  
  
  RESULTS
  Based on model calculations, a hypothetical 400-bed hospital inserting 3,078 central venous catheters (CVCs) per year is expected to avoid an average of 35 CR-BSIs, 145 local infections, and 281 intensive care unit days annually with the systematic use of CHG-impregnated sponge dressing. Potential hospital net cost savings (mainly because of reduced CR-BSIs with use of the dressing) would be $895,000 annually. Results were robust across a range of values in sensitivity analyses.
  
  
  CONCLUSIONS
  CHG-impregnated sponge dressing is a cost-effective CR-BSI prevention treatment option for patients requiring CVCs. The importance of these results should be considered in the context of federal government and insurance company policies that no longer permit enhanced reimbursement for CR-BSI.
authors.affiliation: Ethicon, Inc, Somerville, NJ. Electronic address: sye2@ITS.JNJ.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Ye
authors.affiliation: Ethicon, Inc, Somerville, NJ.
authors.forename: Marcia
authors.initials: M
authors.lastname: Rupnow
authors.affiliation: Ethicon, Inc, Auneau, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bastide
authors.affiliation: Cemka Eval Outcomes Research and Epidemiology, Bourg la Reine, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Lafuma
authors.affiliation: Ethicon, Inc, Somerville, NJ.
authors.forename: Liza
authors.initials: L
authors.lastname: Ovington
authors.affiliation: Jason and Jarvis Associates, Hilton Head Island, SC.
authors.forename: William R
authors.initials: WR
authors.lastname: Jarvis
mesh_terms: D000891:Anti-Infective Agents, Local / Q000191:economics / Q000627:therapeutic use; D016470:Bacteremia / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D001458:Bandages; D055499:Catheter-Related Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects; D002710:Chlorhexidine / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004866:Equipment Contamination; D006801:Humans; D017063:Outcome Assessment, Health Care; D014481:United States / Q000453:epidemiology
chemical_list: D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine