OBJECTIVES : Catheter-related bloodstream infections(CRBSI) bring huge disease and economic burden to patients and healthcare system. Some studies show that Tegaderm chlorhexidine gluconate (CHG) gel dressing and reduce the CRBSI rate compared with standard intravenous (i.v.) dressing (defined as non-antimicrobial transparent film dressing).To estimate the economic impact of Tegaderm CHG dressing compared with standard dressing, used for insertion site care of short-term central venous catheters (CVC) in Chinese intensive care unit(ICU).

METHODS : A decision tree model was developed to conduct a cost-effectiveness analysis of Tegaderm CHG dressing compared with standard dressing in patients with CVC in ICU. In this model, we considered associated dermatitis, local infection at the catheter insertion site and CRBSI. The effectiveness is the number of CRBSI avoided. Resource use, unit cost, and clinical efficacy were extracted from published literature and validated official documents. The effectiveness, cost and incremental cost-effectiveness ratio (ICER) were calculated. The ICER is the cost per catheter-related bloodstream infections avoided. 1,000 Monte Carlo simulations of 1,000 patients per dressing strategy are used for probabilistic sensitivity analysis to test the robustness of the model.

RESULTS : In basecae analysis, compared with standard dressing, Tegaderm CHG prevents 8.26 infections /1,000 patients and saving 220.30 RMB/patient in patients with CVC in ICU, Tegaderm CHG is dominant strategy. In probabilistic sensitivity analysis, compared with standard dressing, Tegaderm CHG averagely prevents9.62 infections /1,000 patients and saving301.08 RMB/patient in patients with CVC in ICU by 1000 simulations . The cost-effectiveness acceptable curve shows that Tegaderm CHG has a 62.7%~71.8% probability of being cost-effectiveness choice compared to standard dressings when the willingness-to-pay threshold increased from 0 to 150,000 RMB. The basecae results are robust according to the probabilistic sensitivity analysis.

CONCLUSIONS : Compared with standard dressing, Tegaderm CHG is economically dominant (lower CRBSI rate and lower costs) in patients with CVC in Chinese ICU.