Cost and effectiveness thresholds for a catheter care bundle under different perspectives.

All cost thresholds represent nationwide implementation costs over an 18mth period. Costs per ICU can be obtained by dividing each figure by 46 e.g. given RR = 0.34 the cost threshold per ICU for the bundle relative to no intervention equals $4,349,730/46 = $94,559.It is important to note that when both CH/SSD and MR catheters are being considered, the MR catheters are the preferred option where the bundle is dominated for all scenarios except where health benefits are valued at zero and bed-days only at the value of variable costs. Under this scenario where the bundle is dominated the MR catheters are not cost-effective as the cost per QALY exceeds $64,000 and it is the CH/SSD catheters that are preferred, hence the shift in the threshold seen in Figure 3c.