Evidence map›Paper›PMID 34824163›Full record

SynthesisBMJ quality & safety2022

Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review.

Sara G McCleskey, Lili Shek, Jonathan Grein, Hiroshi Gotanda, Laura Anderson, Paul G Shekelle, Emmett Keeler, Sally Morton, Teryl K Nuckols

Open access · greenAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ quality & safety, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 17 citations in OpenAlex.

  1. Risk prediction model for early detection of urinary tract infection in a hospital setting in Australia.Health information management : journal of the Health Information Management Association of Australia · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Sara G McCleskeyDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA sara.mccleskey@cshs.org.ORCID 0000-0001-8974-3270
Lili ShekDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Jonathan GreinDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID 0000-0003-4501-883X
Hiroshi GotandaDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID 0000-0003-4238-0171
Laura AndersonDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Paul G ShekelleDepartment of Medicine, West Los Angeles Vet Administration, Los Angeles, California, USA.
Emmett KeelerRAND Corporation, Santa Monica, California, USA.
Sally MortonKnowledge Enterprise, Arizona State University, Tempe, Arizona, USA.
Teryl K NuckolsDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Cedars-Sinai Medical Center · USArizona State University · USRAND Corporation · USWest Los Angeles College · US

Funding

When Is Quality Improvement Cost Saving, Cost Effective, or Not a Good Value?R01HS022644 · AHRQ · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI NUCKOLS, TERYL · 2013 to 2013
$997k
AHRQ HHS R01 HS022644
6 · The paper itself

Abstract

backgroundHospitals have implemented diverse quality improvement (QI) interventions to reduce rates of catheter-associated urinary tract infections (CAUTIs). The economic value of these QI interventions is uncertain.

objectiveTo systematically review economic evaluations of QI interventions designed to prevent CAUTI in acute care hospitals.

methodsA search of Ovid MEDLINE, Econlit, Centre for Reviews & Dissemination, New York Academy of Medicine's Grey Literature Report, WorldCat, IDWeek conference abstracts and prior systematic reviews was conducted from January 2000 to October 2020.We included English-language studies of any design that evaluated organisational or structural changes to prevent CAUTI in acute care hospitals, and reported programme and infection-related costs.Dual reviewers assessed study design, effectiveness, costs and study quality. For each eligible study, we performed a cost-consequences analysis from the hospital perspective, estimating the incidence rate ratio (IRR) and incremental net cost/savings per hospital over 3 years. Unadjusted weighted regression analyses tested predictors of these measures, weighted by catheter days per study.

resultsFifteen unique economic evaluations were eligible, encompassing 74 hospitals. Across 12 studies amenable to standardisation, QI interventions were associated with a 43% decline in infections (mean IRR 0.57, 95% CI 0.44 to 0.70) and wide ranges of net costs (mean US$52 000, 95% CI -$288 000 to $392 000), relative to usual care.

conclusionsQI interventions were associated with large declines in infection rates and net costs to hospitals that varied greatly but that, on average, were not significantly different from zero over 3 years. Future research should examine specific practices associated with cost-savings and clinical effectiveness, and examine whether or not more comprehensive interventions offer hospitals and patients the best value.

Indexed as

Quality ImprovementUrinary Tract InfectionsCathetersCost-Benefit AnalysisFemaleHospitalsHumansMalecost-effectivenessnosocomial infectionsquality improvement

Identifiers

PMID34824163
PMCPMC9134991
OpenAlexW3216977992

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.