Abstract: SA-OR40
National Estimates of Direct Health Care Costs Associated with Catheter-Related Bloodstream Infection among Hospitalized Hemodialysis Patients in Australia
Session Information
- Dialysis Vascular Access: Research Advances
October 26, 2024 | Location: Room 8, Convention Center
Abstract Time: 05:00 PM - 05:10 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Catiwa, Jayson, The George Institute for Global Health, Sydney, New South Wales, Australia
- Gallagher, Martin P., University of New South Wales SWS Clinical Skills and Simulation, Liverpool, New South Wales, Australia
- Jan, Stephen, The George Institute for Global Health, Sydney, Australia
- Polkinghorne, Kevan, Monash University Department of Epidemiology and Preventive Medicine, Melbourne, Victoria, Australia
- Gray, Nicholas A., Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
- Higgins, Kathryn, The George Institute for Global Health, Sydney, New South Wales, Australia
- Kotwal, Sradha S., The George Institute for Global Health, Sydney, New South Wales, Australia
Background
The risk of hospitalization and complications among hemodialysis (HD) patients increases with catheter-related bloodstream infection (CRBSI). The treatment of HD CRBSI often requires substantial healthcare resource; however, the direct hospitalization cost of CRBSI in adult chronic HD patients in Australia remains unknown.
Methods
We used hospitalization records from each Australian State and Territory (excluding Western Australia) and the Australian and New Zealand Dialysis and Transplant Registry to identify national cohort of patients on chronic HD with a catheter and linked the prospectively collected REDUcing the burden of dialysis Catheter ComplicaTIOns: a National approach (REDUCCTION) trial data to identify HD CRBSI episodes. We used inpatient Australian-modified ICD 10 codes and Australian Refined Diagnosis Related Groups to define HD CRBSI-related admissions between December 2016 to March 2020. The cost per inpatient HD CRBSI episode was determined by multiplying the Australian National Weighted Average Unit (NWAU) to the annual National Efficiency Price, with estimates adjusted to USD in 2024 prices. An NWAU is a measure of health service activity weighted for its clinical complexity. The value of 1.00 NWAU in 2024 is $4,375.93.
Results
Study cohort included 10,341 linked hospitalizations among 3,775 HD patients with incident catheter enrolled into REDUCCTION within the 40-month period. Of these, there were 159 (1.5%) hospitalizations attributed to HD CRBSI across 34 participating HD services, with 83% (n = 133) involving tunneled catheters. Overall, mean age of patients was 59 years, 67% male, and 69% Caucasian. The mean NWAU for inpatient HD CRBSI was 3.88 (SD 3.85) with an attributable adjusted cost of $16,767.01 (SD $16,618.74).
Conclusion
The economic burden of inpatient HD CRBSI among chronic HD patients is substantial in Australia, which forms part of the larger actual costs of all bloodstream infections. This first economic analysis of HD CRBSI in Australia using large, linked datasets, offers invaluable insights into the considerable financial strain on health systems. The estimate of out-of-hospital and other indirect costs (social, carer, etc.) associated with HD CRBSI needs to be evaluated in future studies.
Funding
- Government Support – Non-U.S.