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放射科常规临床环境中中心静脉端口导管和外周静脉穿刺中心静脉导管的放置:成本分析与干预持续时间学习曲线

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.

作者信息

Rotzinger Roman, Gebauer Bernhard, Schnapauff Dirk, Streitparth Florian, Wieners Gero, Grieser Christian, Freyhardt Patrick, Hamm Bernd, Maurer Martin H

机构信息

1 Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

2 Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.

出版信息

Acta Radiol. 2017 Dec;58(12):1468-1475. doi: 10.1177/0284185117695664. Epub 2017 Apr 13.

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.

摘要

背景

中心静脉端口导管(CVPS)和外周静脉穿刺中心静脉导管(PICC)的置入是现代患者护理的一个重要组成部分。在成本意识日益增强的时代,需要更多信息来全面评估这两种操作。目的:对大量患者群体中CVPS和PICC导管的介入放射学植入进行回顾性分析,包括两种方法的成本分析以及对干预持续时间方面学习曲线的研究。材料与方法:检查了2011年1月至2013年12月三年期间在介入放射科进行的所有与CVPS和PICC导管相关的干预操作。记录的患者数据包括性别、静脉穿刺部位以及CVPS或PICC置入的指征。基于设备使用的按比例成本、人员成本和一次性用品支出进行了包括干预时间的成本分析。随着时间推移干预持续时间的减少符合学习曲线。结果:16名放射科医生共进行了2987次干预操作:1777次CVPS和791次PICC导管置入。平均植入时间为22.5±0.6分钟(CVPS)和10.1±0.9分钟(PICC导管)。对于CVPS,这一平均时间是由7名在进行20次CVPS植入后新学习该操作的放射科医生实现的。每次植入的总成本为242欧元(CVPS)和201欧元(PICC导管)。结论:CVPS和PICC导管的介入放射学植入是成熟的操作,住院医生易于学习,且成本较低。

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