Placement of central venous port catheters and peripherally inserted central catheters in the routine clinical setting of a radiology department: analysis of costs and intervention duration learning curve

Abstract

Background Placement of central venous port catheters (CVPS) and peripherally inserted central catheters (PICC) is an integral component of state-of-the-art patient care. In the era of increasing cost awareness, it is desirable to have more information to comprehensively assess both procedures. Purpose To perform a retrospective analysis of interventional radiologic implantation of CVPS and PICC lines in a large patient population including a cost analysis of both methods as well as an investigation the learning curve in terms of the interventions' durations. Material and Methods All CVPS and PICC line related interventions performed in an interventional radiology department during a three-year period from January 2011 to December 2013 were examined. Documented patient data included sex, venous access site, and indication for CVPS or PICC placement. A cost analysis including intervention times was performed based on the prorated costs of equipment use, staff costs, and expenditures for disposables. The decrease in intervention duration in the course of time conformed to the learning curve. Results In total, 2987 interventions were performed by 16 radiologists: 1777 CVPS and 791 PICC lines. An average implantation took 22.5 ± 0.6 min (CVPS) and 10.1 ± 0.9 min (PICC lines). For CVPS, this average time was achieved by seven radiologists newly learning the procedures after performing 20 CVPS implantations. Total costs per implantation were €242 (CVPS) and €201 (PICC lines). Conclusion Interventional radiologic implantations of CVPS and PICC lines are well-established procedures, easy to learn by residents, and can be implanted at low costs.

Cost analysis comparison between peripherally inserted central catheters and implanted chest ports in patients with cancer—A health economic evaluation of the PICCPORT trial

“…In our material, PORT implantation costs were marginally smaller than PICCs, mainly due to the price difference in the pre‐packed PICC kits. In contrast, implantation cost is reported lower for PICCs by both Patel, Rotzinger and Viart (abstract only) . When reporting cost from a healthcare perspective, it is important to include all relevant metrics underlining the inclusion of insertion, maintenance and adverse event‐related cost.…”

Economic evaluation of peripherally inserted central catheter and other venous access devices: A scoping review

“…Results of the literature search and the selection process are presented in Figure 1. Finally, 16 studies 10,13-17, [21][22][23][24][25][26][27][28][29][30] were included.…”

“…The 16 included studies 10,[13][14][15][16][17][21][22][23][24][25][26][27][28][29][30] were published from 1993 to 2018, and most were published in the latest decade. [13][14][15]17,21,24,25,27 The largest number of studies was conducted in the United States (six; 37.5%), 16,23,26,[28][29][30] followed by China (five; 31.25%) 14,17,21,22,27 and Switzerland, Italy, Canada, and Australia (five total). 10,13,15,24,25 There were nine cohort studies, 13,14,16,22,[24][25][26]29,30 five randomized controlled trials (RCTs),…”

“…[13][14][15]17,21,24,25,27 The largest number of studies was conducted in the United States (six; 37.5%), 16,23,26,[28][29][30] followed by China (five; 31.25%) 14,17,21,22,27 and Switzerland, Italy, Canada, and Australia (five total). 10,13,15,24,25 There were nine cohort studies, 13,14,16,22,[24][25][26]29,30 five randomized controlled trials (RCTs), 10,15,17,23,28 and two controlled clinical trials. 21,27 Six of the included studies compared PICCs versus PIVCs for short-term use, 10,17,[21][22][23][24] and most of them concentrated on neonates and pediatric patients (five; 83.3%).…”

Vascular access in cancer patients – clinical implications

“…131 Other studies are mainly retrospective and only a few have a relevant control group (Table 14). [132][133][134][135][136][137][138][139][140][141][142][143] All of these studies differ regarding the access device used, implantation techniques, definitions used, and how clinical outcomes were assessed. Furthermore, they were conducted in healthcare systems with different tariffs for implantation, maintenance, staff and complication management.…”