title: Economic impact of Tegaderm chlorhexidine gluconate (CHG) dressing in critically ill patients.
abstract: To estimate the economic impact of a TegadermTMchlorhexidine gluconate (CHG) gel dressing compared with a standard intravenous (i.v.) dressing (defined as non-antimicrobial transparent film dressing), used for insertion site care of short-term central venous and arterial catheters (intravascular catheters) in adult critical care patients using a cost-consequence model populated with data from published sources.
  
  
  
  A decision analytical cost-consequence model was developed which assigned each patient with an indwelling intravascular catheter and a standard dressing, a baseline risk of associated dermatitis, local infection at the catheter insertion site and catheter-related bloodstream infections (CRBSI), estimated from published secondary sources. The risks of these events for patients with a Tegaderm CHG were estimated by applying the effectiveness parameters from the clinical review to the baseline risks. Costs were accrued through costs of intervention (i.e. Tegaderm CHG or standard intravenous dressing) and hospital treatment costs depended on whether the patients had local dermatitis, local infection or CRBSI. Total costs were estimated as mean values of 10,000 probabilistic sensitivity analysis (PSA) runs.
  
  
  
  Tegaderm CHG resulted in an average cost-saving of £77 per patient in an intensive care unit. Tegaderm CHG also has a 98.5% probability of being cost-saving compared to standard i.v. dressings.
  
  
  
  The analyses suggest that Tegaderm CHG is a cost-saving strategy to reduce CRBSI and the results were robust to sensitivity analyses.
authors: Health Economics and Decision Science, School of Health and Related Research, The University of Sheffield, Sheffield, UK.
authors: Praveen
authors: P
authors: Thokala
authors: 3M United Kingdom PLC, Morley St, Loughborough, UK.
authors: Martin
authors: M
authors: Arrowsmith
authors: Health Economics and Decision Science, School of Health and Related Research, The University of Sheffield, Sheffield, UK.
authors: Edith
authors: E
authors: Poku
authors: Health Economics and Decision Science, School of Health and Related Research, The University of Sheffield, Sheffield, UK.
authors: Marissa
authors: M
authors: Martyn-St James
authors: Evidera, Metro Building, London, UK.
authors: Jeff
authors: J
authors: Anderson
authors: 3M United Kingdom PLC, Morley St, Loughborough, UK.
authors: Steve
authors: S
authors: Foster
authors: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK.
authors: Tom
authors: T
authors: Elliott
authors: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK.
authors: Tony
authors: T
authors: Whitehouse
keywords: Tegaderm chlorhexidine gluconate (CHG); adult critical care; arterial catheters; bloodstream infection; catheter-related bloodstream infection (CRBSI); central venous catheter (CVC); chlorhexidine dressing; cost model; cost-effectiveness; vascular access