BENEFIT-COST ANALYSIS OF CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTION (CLABSI) BUNDLE CARE IN TERTIARY CARE HOSPITALS OF INDIA...
Author(s)
Dhaval Parmar, PhD1, Medha Wadhwa, PhD1, Devang Raval, MPH1, Somen Saha, PhD1, Archana Thakur, MD1, Junaid KP, PhD1, Astha Vala, MD2, Dr A. M. Kadri, MD2, Deepak B. Saxena, PhD1.
1Indian Institute of Public Health Gandhinagar, Gandhinagar, India, 2State Health System Resource Centre Gujarat, Gandhinagar, India.
1Indian Institute of Public Health Gandhinagar, Gandhinagar, India, 2State Health System Resource Centre Gujarat, Gandhinagar, India.
OBJECTIVES: Central line-associated bloodstream infections (CLABSIs) are among the most important healthcare-associated infections in intensive care settings and are associated with increased morbidity, prolonged hospitalization, and higher treatment costs. This study evaluated the economic value of implementing a CLABSI prevention bundle in tertiary care hospitals.
METHODS: A benefit-cost analysis (BCA) was conducted in two tertiary care hospitals in Gujarat, India, using provider perspective costing. Hospital-level surveillance data for 2024 were used, including central line-days, CLABSI cases, and bundle compliance. Bundle components included hand hygiene, maximal sterile barrier precautions, chlorhexidine skin antisepsis, hub disinfection, aseptic line handling, and dressing care. Incremental costs included consumables, human resource time, and administrative overheads. Expected CLABSI cases were estimated using International Nosocomial Infection Control Consortium (INICC) benchmark rates. Economic benefit was estimated using inflation-adjusted attributable cost per CLABSI episode. Benefit-cost ratio (BCR), net monetary benefit (NMB), opportunity cost, and one-way sensitivity analysis were performed.
RESULTS: Hospital C demonstrated higher bundle compliance (98%) and lower CLABSI rate (0.45 per 1000 catheter-days) compared with Hospital B (91% compliance; 0.83 per 1000 catheter-days). Expected CLABSI cases were estimated at 57 and 12 for Hospitals C and B, respectively. Bundle implementation prevented 52 CLABSI cases in Hospital C and 10 cases in Hospital B. Total annual bundle cost was USD 22,300 for Hospital C and USD 4780 for Hospital B. The resulting economic benefits were USD 90,300 and USD 17,700, respectively. BCRs were 4.05 for Hospital C and 3.70 for Hospital B, with positive NMB observed in both hospitals. Sensitivity analysis demonstrated robustness of findings across all tested scenarios.
CONCLUSIONS: Implementation of CLABSI bundle care was associated with favorable economic outcomes, with benefits substantially exceeding implementation costs. Sustained adherence to bundle practices may provide both clinical and financial advantages in tertiary care settings.
METHODS: A benefit-cost analysis (BCA) was conducted in two tertiary care hospitals in Gujarat, India, using provider perspective costing. Hospital-level surveillance data for 2024 were used, including central line-days, CLABSI cases, and bundle compliance. Bundle components included hand hygiene, maximal sterile barrier precautions, chlorhexidine skin antisepsis, hub disinfection, aseptic line handling, and dressing care. Incremental costs included consumables, human resource time, and administrative overheads. Expected CLABSI cases were estimated using International Nosocomial Infection Control Consortium (INICC) benchmark rates. Economic benefit was estimated using inflation-adjusted attributable cost per CLABSI episode. Benefit-cost ratio (BCR), net monetary benefit (NMB), opportunity cost, and one-way sensitivity analysis were performed.
RESULTS: Hospital C demonstrated higher bundle compliance (98%) and lower CLABSI rate (0.45 per 1000 catheter-days) compared with Hospital B (91% compliance; 0.83 per 1000 catheter-days). Expected CLABSI cases were estimated at 57 and 12 for Hospitals C and B, respectively. Bundle implementation prevented 52 CLABSI cases in Hospital C and 10 cases in Hospital B. Total annual bundle cost was USD 22,300 for Hospital C and USD 4780 for Hospital B. The resulting economic benefits were USD 90,300 and USD 17,700, respectively. BCRs were 4.05 for Hospital C and 3.70 for Hospital B, with positive NMB observed in both hospitals. Sensitivity analysis demonstrated robustness of findings across all tested scenarios.
CONCLUSIONS: Implementation of CLABSI bundle care was associated with favorable economic outcomes, with benefits substantially exceeding implementation costs. Sustained adherence to bundle practices may provide both clinical and financial advantages in tertiary care settings.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE75
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas