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{
    "pk": 16583,
    "title": "Economic Evaluation of Ultrasound-guided Central Venous Catheter Confirmation vs Chest Radiography in Critically Ill Patients: A Labor Cost Model",
    "subtitle": null,
    "abstract": "Introduction:\n Despite evidence suggesting that point-of-care ultrasound (POCUS) is faster and non-inferior for confirming position and excluding pneumothorax after central venous catheter (CVC) placement compared to traditional radiography, millions of chest radiographs (CXR) are performed annually for this purpose. Whether the use of POCUS results in cost savings compared to CXR is less clear but could represent a relative advantage in implementation efforts. Our objective in this study was to evaluate the labor cost difference for POCUS-guided vs CXR-guided CVC position confirmation practices.\nMethods:\n We developed a model to evaluate the per patient difference in labor cost between POCUS-guided vs CXR-guided CVC confirmation at our local urban, tertiary academic institution. We used internal cost data from our institution to populate the variables in our model. \nResults: \nThe estimated labor cost per patient was $18.48 using CXR compared to $14.66 for POCUS, resulting in a net direct cost savings of $3.82 (21%) per patient using POCUS for CVC confirmation. \nConclusion:\n In this study comparing the labor costs of two approaches for CVC confirmation, the more efficient alternative (POCUS-guided) is not more expensive than traditional CXR. Performing an economic analysis framed in terms of labor costs and work efficiency may influence stakeholders and facilitate earlier adoption of POCUS for CVC confirmation.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "central venous catheter"
        },
        {
            "word": "ultrasonography interventional"
        },
        {
            "word": "Chest radiograph"
        },
        {
            "word": "cost analysis, POCUS"
        }
    ],
    "section": "Technology in Emergency Medicine",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/1709s9wp",
    "frozenauthors": [
        {
            "first_name": "Enyo",
            "middle_name": "A.",
            "last_name": "Ablordeppey",
            "name_suffix": "",
            "institution": "Washington University School of Medicine, Department of Anesthesiology, St. Louis, Missouri; Washington University School of Medicine, Department of Emergency Medicine, St. Louis, Missouri",
            "department": "None"
        },
        {
            "first_name": "Adam",
            "middle_name": "M.",
            "last_name": "Koenig",
            "name_suffix": "",
            "institution": "Washington University School of Medicine, Department of Emergency Medicine, St. Louis, Missouri",
            "department": "None"
        },
        {
            "first_name": "Abigail",
            "middle_name": "R.",
            "last_name": "Barker",
            "name_suffix": "",
            "institution": "Washington University, Center for Health Economics and Policy at the Institute for Public Health, St. Louis, Missouri",
            "department": "None"
        },
        {
            "first_name": "Emily",
            "middle_name": "E.",
            "last_name": "Hernandez",
            "name_suffix": "",
            "institution": "Washington University, Center for Health Economics and Policy at the Institute for Public Health, St. Louis, Missouri",
            "department": "None"
        },
        {
            "first_name": "Suzanne",
            "middle_name": "M.",
            "last_name": "Simkovich",
            "name_suffix": "",
            "institution": "Medstar Health Research Institute, Division of Healthcare Delivery Research, Hyattsville, Maryland; Georgetown University School of Medicine, Department of Medicine, Washington, DC",
            "department": "None"
        },
        {
            "first_name": "James",
            "middle_name": "G.",
            "last_name": "Krings",
            "name_suffix": "",
            "institution": "Washington University School of Medicine, Division of Pulmonary Critical Care Medicine, Department of Medicine, St. Louis, Missouri",
            "department": "None"
        },
        {
            "first_name": "Derek",
            "middle_name": "S.",
            "last_name": "Brown",
            "name_suffix": "",
            "institution": "Washington University in St. Louis, Brown School, St. Louis, Missouri",
            "department": "None"
        },
        {
            "first_name": "Richard",
            "middle_name": "T.",
            "last_name": "Griffey",
            "name_suffix": "",
            "institution": "Washington University School of Medicine, Department of Emergency Medicine, St. Louis, Missouri",
            "department": "None"
        }
    ],
    "date_submitted": "2022-02-21T03:05:54Z",
    "date_accepted": "2022-02-21T03:05:54Z",
    "date_published": "2022-09-15T17:28:17Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/16583/galley/8388/download/"
        }
    ]
}