Cost minimization analysis of outpatient parenteral/oral antibiotic therapy at a trauma hospital: Public health system

Abstract

Objective: To evaluate the impact of outpatient parenteral antimicrobial therapy (OPAT) on a public hospital in a middle-income country. Design: A retrospective, observational study analyzing the economic data retrieved on the dehospitalization of patients on antibiotic therapy. Setting: Public university trauma hospital. Patients: Data were collected from June 2017 to May 2020. Antibiotic cost, hospital length of stay, and risk of multidrug-resistant (MDR) infection or colonization were reviewed, along with the break-even point at which a balance occurs between OPAT antimicrobial costs and all in-hospital costs. A cumulative risk curve was constructed showing the incidence of MDR during the review period. Results: In total, 225 patients were studied. The implementation of OPAT resulted in a reduction of $156,681 (49.6%), which is equivalent to an average of $696 per patient, as well as a shortened length of stay, from 33.5 to 15.7 days. OPAT reduces the risk of acquiring infection by MDR bacteria by having the final treatments administered outside of the hospital environment. The breakeven curves, comparing the duration of the OPAT to daily medication costs, allowed for the prediction of the time and dollar costs of antibiotic therapy. Conclusions: OPAT presented a significant cost savings, shortened length of stay, and reduced risk of contamination of patients by MDR.

A atuação do enfermeiro e dos cuidadores na assistência ao paciente portador de demência / The performance of nurses and caregivers in care for patients with dementia

“…This was an important issue in our study because there was an increase in the MRSA incidence, increasing the consume of vancomycin and linezolid. This epidemiology chance in the hospital is the prove that studies based only in simulations should be carefully evaluated before implementation in the hospital routine 33 .…”

“…In the figure 5, the horizontal line is the total vancomycin costs, and the inclined line is the total cost of linezolid according with the price of the drug. When the lines cross, is the ideal price of linezolid to be considered in the hospital 33…”

Cost-minimization in Health: Linezolid versus vancomycin with serum monitoring in patients with incipient renal failure – a simulation and real-life / Minimização de custos em Saúde: Linezolida versus vancomicina com monitoramento sérico em pacientes com insuficiência renal incipiente - uma simulação e vida real

“…In resume, linezolid implementation as a strategy to avoid vancomycin with VSL is not cost-effective 33,34 . The panorama of each hospital must be carefully evaluated before strategies like we implemented, because the incidence of MRSA can be an important variable and the monitoring of VSL continues to be an important approach to achieve an ide al Pk/Pd parameter for treatment.…”

The impact of VITEK 2 implementation for identification and susceptibility testing of microbial isolates in a Brazilian public hospital

“…This study was conducted between January 2017 and July 2017 (conventional method period [CMP]) and August 2017 to December 2017 (automated method period [AMP]). This hospital has an active ASP and diagnostic stewardship programme that has been described in previous publications [9][10][11].…”