• Fatimah Sarah Hospital Administration Department, Faculty of Public Health, University of Indonesia
  • Oktaminati Puput Faculty of Public Health, University of Indonesia


dults, inpatient, indwelling catheter urinary, prevention, intervention, cost and financial economic impact


Background: Catheter-associated urinary tract infections (CAUTI) was the first condition chosen for nonpayment because of its anticipated effect on large numbers of hospitalizations. The risk of CAUTI is mainly related to the duration of catheterization, occurring at a rate of 5% per day. This study is to identify the cost and financial economic impact of intervention and prevention including an indication of CAUTI, number of events, duration of urinary catheterization, length of stay, the cost for antibiotics and
hospitalization cost in catheter-associated urinary tract infection (CAUTI) to reducing the rate and hospital payment. 

Methods: Systematic Review with PRISMA – P Protocol in 2009 method from a relevant database such as PubMed and ProQuest search engine in 2007 until 2017. Total document selected by full text is 10 article.

Results: Based on literature search and screening article after using intervention and prevention strategy for CAUTI in the USA, UK and Thailand have a good impact in the duration of urinary catheterization, length of stay, the cost for antibiotic and hospitalization cost. Some article result that the change in the rate of CAUTI was not significantly different before and after the policy and validity in identifying CAUTI is limited. 

Conclusions: Cost impact in catheter-associated urinary tract infections (CAUTI) can preventable by reducing unnecessary urinary catheter use (appropriate indication), shortening catheter duration, bladder bundles intervention, supervision, and evaluation of the implementation. 



Meddings J.A. et al. Reducing Unnecessary Urinary Catheter Use and Other Strategies to Prevent Catheter-Associated Urinary Tract Infection: An Integrative Review. BMJ QualSaf. 2014; 23:277-289.

Pickard R, et al. Types of Urethral Catheter for Reducing Symptomatic Urinary Tract Infections in Hospitalized Adults Requiring Short- Term Catheterization: Multicenter Randomized Controlled Trial and Economic Evaluation of Antimicrobial and Antiseptic Impregnated Urethral Catheters (The Catheter Trial).Health Technology Assesment.2012; Vol 16: No.47.

Meddings, J.A. et al. Impact of Non Payment for Hospital-Acquired Catheter-Associated Urinary Tract Infection: A Statewide Analysis. National Institutes of Health, Annual of Internal Medicine.2012; 157(5):305-312.

Apisarnthanarak Anucha, et al. Effectiveness of Multifaceted Hospital-wide Quality Improvement Programs Featuring an Intervention To Remove Unnecessary Urinary Catheters at a Tertiary Care Center in Thailand. Infection Control and Hospital Epidemiology. 2007; Vol. 28:No.7.

Sutherland, al. A Single-Center Multidisciplinary Initiative to Reduce Catheter-Associated Urinary Tract Infection Rates Quality and Financial Implications. The health care manager. 2015; 34(3): 218-224.

Palmer J.A. et al. Including Catheter – Associated Urinary Tract Infections in the 2008 CMS Payment Policy: A Qualitative Analysis. Urologic Nursing.2013; 33(1): 15-23.

Schuller, K. et al. Initial impact of Medicare’s nonpayment policy on catheter-associated urinary tract infections by hospital characteristics. Elsevier. Health policy. 2013: 165-171.

Tambyah, A Paul. The Direct Costs of Nosocomial Catheter associated Urinary Tract Infection in The Era of Managed Care. Infection Control and Hospital Epidemiology.2014; 23(1):27 – 31.

Trautner, B. Management of Catheter-Associated Urinary Tract Infection (CAUTI). National Institutes of Health CurrOpin Infect Dis. 2010; 23(1):76-82.

Zhan, C. et al. Identification of Hospital-Acquired Catheter-Associated Urinary Tract Infections from Medicare Claims Sensitivity and Positive Predictive Value. Medical Care.2009; 47(3):364-369.

Wald H et al. Chief Nursing Officers’ Perspectives on Medicare’s Hospital-Acquired Conditions Nonpayment Policy: Implications for Policy Design and Implementation. Implementation Science.2012;7:78

Meddings J, et al. Effect of Nonpayment for Hospital –Acquired, Catheter-Associated Urinary Tract Infection a Statewide Analysis. Annals of Internal Medicine.2012;157:305-312

Kawai Tse A, et al. Impact of the Center for Medicare and Medicaid Services Hospital-Acquired Conditions Policy on Billing Rates for 2 Targeted Healthcare – Associated Infections. Infection Control and Hospital Epidemiology.2015; 36 (8):871-877.

Singh S, et al. Improving Outcomes and Reducing Cost by Modular Training Infection Control in a Resource-Limited Setting. International Journal for Quality in Health Care. 2012; 24 (6):641-648.

Galiczewski M J. Interventions for Prevention of Catheter Associated Urinary tract Infections in Intensive Care Units: an Integrative Review. Intensive and Critical Care Nursing. Elsevier. 2016; 32:1-11.

FPM Cooper, CE Alexander, S Sinha, MI Omar. Policies for Replacing Long – Term Indwelling Urinary Catheters in Adults (Review). Cochrane Database of Systematic Reviews.2016; 7(CD011115).

Chenoweth C, Saint S. Preventing Catheter-Associated urinary tract Infections in the Intensive Care Unit. Critical Care Clin.2013; 29:19- 32.

TBL Lam, et al. Types of Indwelling Urethral Catheter for Short-Term Catheterization in Hospitalized Adults (Review). Cochrane Database of Systematic Reviews.2014; 9(CD004013).



How to Cite

Sarah, F., & Puput, O. (2018). COST AND FINANCIAL ECONOMIC IMPACT IN CATHETER ASSOCIATED URINARY TRACT INFECTION (CAUTI): A SYSTEMATIC REVIEW. Proceedings of the International Conference on Applied Science and Health, (3), 257–265. Retrieved from