Análise econômica: cateter central periférico vs. cateter curto em antibioticoterapia domiciliar prolongada
DOI:
https://doi.org/10.15649/cuidarte.4124Palavras-chave:
Pacientes Ambulatoriais, Cateterismo Periférico, Catéteres, Infecções Relacionadas a Cateter, Trombose de Veia ProfundaResumo
Introdução: Programas de hospital em casa dependem de dispositivos de acesso vascular para administração segura de antimicrobianos parenterais. Enquanto as diretrizes recomendam Peripherally Inserted Central Catheters (PICC) para tratamentos ≥14 dias, Short Peripheral Catheters (SPC) são frequentemente usados. Estudos de custo-efetividade comparando esses dispositivos e suas complicações são limitados. Objetivo: Este estudo conduziu uma avaliação econômica comparando PICC e SPC para terapia antibiótica parenteral ambulatorial de pacientes. Materiais e Métodos: Uma revisão de literatura das frequências de complicações do cateter rendeu 1.053 artigos, reduzidos para 18 após revisão por pares independente. Especialistas foram consultados e uma lista de itens necessários para o uso do cateter foi compilada para determinar os custos. Um modelo de árvore de decisão foi desenvolvido com base nas frequências e custos das complicações. Os resultados foram analisados usando Incremental Cost-Effectiveness Ratios (ICER), análise de sensibilidade univariada (diagrama de tornado) e análise de sensibilidade multivariada (simulação de Monte Carlo). Resultados: As complicações maiores foram semelhantes entre os dispositivos, mas as complicações menores foram mais frequentes com o SPC. O caso de referência do PICC assumiu 50%-50% de inserção por radiologista/enfermeiro, custo do cateter ($74,7), tratamento ≤15 dias e prevalência de complicações. Custos mais altos associados ao PICC foram vinculados ao material do cateter e à inserção do radiologista. A análise multivariada mostrou ICERs de $49,2 com 90% de inserção liderada por enfermeiros e $24,3 com 100% de inserção liderada por enfermeiros, assumindo uma redução de 50% no preço do PICC. Discussão: O PICC foi mais eficaz na redução de complicações menores. Os custos diminuíram com inserções lideradas por enfermeiros e menores custos com material do cateter. Conclusões: Aumentar o uso do PICC para tratamentos prolongados pode reduzir os custos gerais e diminuir os ICERs, destacando seu potencial vantagem econômica, apesar das maiores despesas iniciais.
Como citar este artigo: Vélez- Bonilla Mariana, Hernández- Flórez Catalina, Solano-Felizzola Allan, Amado-Garzón Sandra B, Rosselli Diego. Economic analysis: PICC versus short catheter for prolonged home antibiotic therapy. Revista Cuidarte. 2025;16(2):e4124. https://doi.org/10.15649/cuidarte.4124
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