Presentation (CTI)

OBJECTIVES: Catheter-associated urinary tract infection (CAUTI) remains a major healthcare-associated infection associated with increased morbidity, prolonged hospitalization, and additional treatment costs. This study evaluated the economic impact of implementing CAUTI bundle care across tertiary hospitals in Gujarat, India.
METHODS: A benefit-cost analysis (BCA) was conducted across three tertiary hospitals using 2024 surveillance and costing data. Incremental costs attributable to CAUTI bundle implementation were estimated from the provider perspective and included consumables, human resource costs, and administrative overheads. Bundle activities included aseptic catheter insertion, catheter maintenance, and infection control monitoring. Expected CAUTI cases were estimated using International Nosocomial Infection Control Consortium (INICC) benchmark rates and compared with observed cases to estimate infections prevented. Monetary benefit was calculated using inflation-adjusted attributable CAUTI treatment cost derived from published Indian literature. Benefit-cost ratio (BCR), net monetary benefit, opportunity cost, and one-way sensitivity analysis were performed.
RESULTS: Hospitals with higher bundle compliance demonstrated lower CAUTI rates and better economic outcomes. Hospital C (95% compliance) and Hospital B (94% compliance) achieved CAUTI rates of 0.49 and 0.51 per 1000 catheter-days, respectively, whereas Hospital A (65% compliance) reported a higher rate of 3.4 per 1000 catheter-days. Hospital C prevented 30 infections and Hospital B prevented 19 infections, resulting in BCRs of 2.31 and 2.33, respectively. In contrast, Hospital A demonstrated negative economic benefit with a BCR of -1.64. Consumables constituted the largest proportion of bundle implementation cost (76-82%). Sensitivity analysis showed that the model was most sensitive to variation in infections prevented and attributable CAUTI cost.
CONCLUSIONS: CAUTI bundle care was economically beneficial in hospitals with high compliance, demonstrating that investments in infection prevention can generate substantial clinical and financial gains. Strengthening adherence to catheter care practices and surveillance mechanisms may improve both infection outcomes and economic efficiency in resource-constrained hospital settings.