DIRECT COST OF CATHETER-RELATED BLOODSTREAM INFECTION AMONG HOSPITALISED HAEMODIALYSIS-DEPENDENT PATIENTS IN AUSTRALIA: EVIDENCE FROM A DATA LINKAGE STUDY
Mr Jayson Catiwa1,2, Professor MARTIN GALLAGHER2,3, Professor STEPHEN JAN2,4, Adjunct (Clinical) Professor KEVAN R POLKINGHORNE5,6, Associate Professor NICHOLAS A GRAY7,8, Dr KATHRYN HIGGINS2, Associate Professor (Conjoint) SRADHA KOTWAL2,9
1St George Hospital, Kogarah, Australia, 2The George Institute for Global Health, Sydney, Australia, 3South Western Sydney Clinical School, UNSW, , Australia , 4Centre for Health Economics and Policy Innovation Business School, Imperial College London, , United Kingdom, 5Department of Epidemiology and Preventive Medicine, Monash University, , Australia, 6Departments of Nephrology & Medicine, Monash Medical Centre, Monash University, , Australia, 7Sunshine Coast University Hospital, Birtinya, Australia , 8University of the Sunshine Coast, Sippy Downs, Australia, 9Prince of Wales Hospital, UNSW, Sydney, Australia
Aim: To calculate the hospitalisation cost of catheter-related bloodstream infection (CRBSI) among haemodialysis (HD)-dependent adult patients in Australia.
Background: HD-CRBSI increases hospitalisation risk, incurring higher costs and complications. The REDUcing the burden of dialysis Catheter ComplicaTIOns: a National approach (REDUCCTION) trial showed 1 in 10 patients dialysing through a catheter for a year will experience an episode of HD-CRBSI. However, the cost of each HD-CRBSI episode in Australia remains unknown.
Method: We linked the prospectively collected REDUCCTION trial data with hospitalisation records from each Australian State and Territory (excluding Western Australia) and to the Australian and New Zealand Dialysis and Transplant Registry to identify HD-CRBSI-related admissions of adult patients with catheters between December 2016 to March 2020. We used International Classification of Diseases 10th Revision and Australian Refined Diagnosis Related Groups to identify HD-CRBSI and estimate costs of HD-CRBSI-related admissions. The cost per HD-CRBSI episode was determined by multiplying the Australian National Weighted Average Unit (NWAU) to the annual National Efficiency Price (NEP), with estimates adjusted to 2024 prices.
Results: There were 159 HD-CRBSI-related hospitalisations recorded across 34 participating health services over 40 months, with 83% (n=133) involving tunnelled catheters. The mean NWAU was 3.88 (standard deviation [SD] 3.85) with an attributable cost of AU$25,099.43 (SD AU$24,877.64). Overall aggregate inpatient cost of HD-CRBSI across the participating health services amounted to AU$3.9 million.
Conclusion: HD-CRBSI-related hospitalisations represent a substantial economic burden among HD-dependent adult patients in Australia. Our total cost estimate is likely an underrepresentation of the actual costs of all bloodstream infections. This first economic analysis of HD-CRBSI in Australia using large, linked datasets, provides robust insights into the considerable financial strain on health services.
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Biography:
Jayson is an accomplished advanced renal practitioner being a Clinical Nurse Consultant in Renal Vascular Access at a large tertiary hospital in Sydney, and a Clinical Research Coordinator at a leading international dialysis provider. Jayson has a diverse background in healthcare, having worked both locally and overseas, providing comprehensive nursing care across all ages. Passionate about driving transformative change in nephrology, Jayson blends evidence-based research with hands-on patient care. As a bonafide member of multiple professional organisations in renal nursing and medicine, he strives to improve patient outcomes through innovative solutions and possesses a deep understanding of renal care complexities.