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Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model

INTRODUCTION: Despite evidence suggesting that point-of-care ultrasound (POCUS) is faster and non-inferior for confirming position and excluding pneumothorax after central venous catheter (CVC) placement compared to traditional radiography, millions of chest radiographs (CXR) are performed annually...

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Autores principales: Ablordeppey, Enyo A., Koenig, Adam M., Barker, Abigail R., Hernandez, Emily E., Simkovich, Suzanne M., Krings, James G., Brown, Derek S., Griffey, Richard T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9541994/
https://www.ncbi.nlm.nih.gov/pubmed/36205669
http://dx.doi.org/10.5811/westjem.2022.7.56501
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author Ablordeppey, Enyo A.
Koenig, Adam M.
Barker, Abigail R.
Hernandez, Emily E.
Simkovich, Suzanne M.
Krings, James G.
Brown, Derek S.
Griffey, Richard T.
author_facet Ablordeppey, Enyo A.
Koenig, Adam M.
Barker, Abigail R.
Hernandez, Emily E.
Simkovich, Suzanne M.
Krings, James G.
Brown, Derek S.
Griffey, Richard T.
author_sort Ablordeppey, Enyo A.
collection PubMed
description INTRODUCTION: Despite evidence suggesting that point-of-care ultrasound (POCUS) is faster and non-inferior for confirming position and excluding pneumothorax after central venous catheter (CVC) placement compared to traditional radiography, millions of chest radiographs (CXR) are performed annually for this purpose. Whether the use of POCUS results in cost savings compared to CXR is less clear but could represent a relative advantage in implementation efforts. Our objective in this study was to evaluate the labor cost difference for POCUS-guided vs CXR-guided CVC position confirmation practices. METHODS: We developed a model to evaluate the per patient difference in labor cost between POCUS-guided vs CXR-guided CVC confirmation at our local urban, tertiary academic institution. We used internal cost data from our institution to populate the variables in our model. RESULTS: The estimated labor cost per patient was $18.48 using CXR compared to $14.66 for POCUS, resulting in a net direct cost savings of $3.82 (21%) per patient using POCUS for CVC confirmation. CONCLUSION: In this study comparing the labor costs of two approaches for CVC confirmation, the more efficient alternative (POCUS-guided) is not more expensive than traditional CXR. Performing an economic analysis framed in terms of labor costs and work efficiency may influence stakeholders and facilitate earlier adoption of POCUS for CVC confirmation.
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spelling pubmed-95419942022-10-11 Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model Ablordeppey, Enyo A. Koenig, Adam M. Barker, Abigail R. Hernandez, Emily E. Simkovich, Suzanne M. Krings, James G. Brown, Derek S. Griffey, Richard T. West J Emerg Med Technology in Emergency Medicine INTRODUCTION: Despite evidence suggesting that point-of-care ultrasound (POCUS) is faster and non-inferior for confirming position and excluding pneumothorax after central venous catheter (CVC) placement compared to traditional radiography, millions of chest radiographs (CXR) are performed annually for this purpose. Whether the use of POCUS results in cost savings compared to CXR is less clear but could represent a relative advantage in implementation efforts. Our objective in this study was to evaluate the labor cost difference for POCUS-guided vs CXR-guided CVC position confirmation practices. METHODS: We developed a model to evaluate the per patient difference in labor cost between POCUS-guided vs CXR-guided CVC confirmation at our local urban, tertiary academic institution. We used internal cost data from our institution to populate the variables in our model. RESULTS: The estimated labor cost per patient was $18.48 using CXR compared to $14.66 for POCUS, resulting in a net direct cost savings of $3.82 (21%) per patient using POCUS for CVC confirmation. CONCLUSION: In this study comparing the labor costs of two approaches for CVC confirmation, the more efficient alternative (POCUS-guided) is not more expensive than traditional CXR. Performing an economic analysis framed in terms of labor costs and work efficiency may influence stakeholders and facilitate earlier adoption of POCUS for CVC confirmation. Department of Emergency Medicine, University of California, Irvine School of Medicine 2022-09 2022-09-15 /pmc/articles/PMC9541994/ /pubmed/36205669 http://dx.doi.org/10.5811/westjem.2022.7.56501 Text en Copyright: © 2022 Ablordeppey et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Technology in Emergency Medicine
Ablordeppey, Enyo A.
Koenig, Adam M.
Barker, Abigail R.
Hernandez, Emily E.
Simkovich, Suzanne M.
Krings, James G.
Brown, Derek S.
Griffey, Richard T.
Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model
title Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model
title_full Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model
title_fullStr Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model
title_full_unstemmed Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model
title_short Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model
title_sort economic evaluation of ultrasound-guided central venous catheter confirmation vs chest radiography in critically ill patients: a labor cost model
topic Technology in Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9541994/
https://www.ncbi.nlm.nih.gov/pubmed/36205669
http://dx.doi.org/10.5811/westjem.2022.7.56501
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