Rethinking Paediatric CVAD Costs: What the Evidence Really Shows

Study Overview

This systematic review synthesised paediatric studies to quantify the financial burden of central venous access device (CVAD) complications and to examine how those costs are calculated. Infectious complications dominated both the literature and the spend, while reporting of costing methods was often incomplete—making cross-hospital comparisons difficult.

Key Findings

• Infectious complications are expensive: pooled mean ? USD $77,000 per event, with single-study estimates ranging from a few thousand dollars to well over $300,000.
• Non-infectious events vary widely: pooled mean ? USD $350 per event; individual estimates ranged from negligible amounts (minor insertion issues) to tens of thousands (e.g., venous stenosis).
• Setting and case-mix matter: the highest pooled costs came from studies in high-acuity services (e.g., paediatric haematology/oncology).
• Methods transparency is poor: only a small fraction of studies clearly described their costing approach (e.g., which resources were counted and how prices were applied).
• Heterogeneous data sources: many studies mixed hospital databases and patient records, but about half didn’t specify which cost items were included, limiting comparability.

Implications

Hospitals should build local cost baselines for CVAD complications instead of relying on headline figures. The biggest savings still come from preventing infections, followed by targeted strategies in high-risk services. Future research should use transparent, standardised costing methods (clearly listing resources, quantities, and prices) to enable apples-to-apples comparisons and more reliable business cases for prevention.

Read more:https://www.journalofhospitalinfection.com/article/S0195-6701(25)00365-2/fulltext 

Authors: Elouise R. Comber, Amanda J. Ullman, Stephanie Hall, Mari Takashima, Linda Nguyen, Samantha Keogh, Joshua Byrnes