Table 1. Overview of Variables and Values.
Variable | Base Case | High | Low | Reference | |||
---|---|---|---|---|---|---|---|
Intervention Costs (per year): | $145,000.00 | $217,500.00 | $72,500.00 | Waters16 | |||
| |||||||
CLABSI | VAP | CLABSI | VAP | CLABSI | VAP | ||
Base Case | Base Case | Reference | |||||
| |||||||
Index ICU Stay: | |||||||
| |||||||
Device Days | |||||||
Usual care comparator | 3324 | 2918 | - | - | - | - | NNIS 200417 |
Multifaceted infection prevention program | 2846 | 2028 | 4269 | 3042 | 1423 | 1014 | NHSN 201118 |
| |||||||
Incidence (per 1000 device days) | |||||||
Usual care comparator | 5.0 | 4.9 | - | - | - | - | NNIS 200417 |
Multifaceted infection prevention program | 1.2 | 1.1 | 4.8 | 4.7 | 0.0 | 0.0 | NHSN 201118 |
| |||||||
Attributable Death Rate | 0.160 | 0.103 | 0.250 | 0.161 | 0.120 | 0.077 | Eber3 |
| |||||||
Costs | |||||||
Inpatient $ / HAI case | $16,155.00 | $21,163.00 | $24,232.50 | $31,744.50 | $8,077.50 | $10,581.50 | CDC2 |
| |||||||
Base Case | High | Low | Reference | ||||
| |||||||
Post-index ICU stay experiences: | |||||||
| |||||||
Discount rate | 3% | 5% | 0% | ||||
| |||||||
Quality of life decrements | |||||||
Hospital admission* | 0.121 | 0.182 | 0.061 | Scherbaum30 | |||
Home care day** | 0.570 | 0.855 | 0.285 | ||||
Long-term care day** | 0.570 | 0.855 | 0.285 | ||||
Emergency room visit day** | 0.400 | 0.600 | 0.200 | ||||
Age 65*** | 0.200 | ||||||
Age > 65 / per year*** | 0.005 | Wagner31 | |||||
| |||||||
Costs | |||||||
Hospital day | $2,048.36 | $3,072.54 | $1,024.18 | ||||
Home care day | $143.83 | $215.75 | $71.92 | ||||
Emergency room visit | $5,655.57 | $8,483.36 | $2,827.79 | ||||
Long-term care day | $99.54 | $149.30 | $49.77 |
The hospital admission utility decrement is an annual decrement
The home care, long-term care, and emergency room decrements are per day
We apply an age-based decrement to utility, setting QALY to 0.80 at age 65 and decreasing by 0.005 per year thereafter (See Wagner31).
CLABSI: Central Line-Associated Bloodstream Infections, HAI: Healthcare-Associated Infections, ICU: Intensive Care Unit, QALY: Quality-Adjusted Life Years, VAP: Ventilator-Associated Pneumonia