Costs of outpatient parenteral antimicrobial therapy (OPAT) administered by Hospital at Home units in Spain

Ramallo, Víctor José González; Mirón-Rubio, Manuel; Mujal, Abel; Estrada, Oriol; Forné, Carles; Aragón, Belén; Rivera, Antonio José

doi:10.1016/j.ijantimicag.2017.02.017

Cited by 37 publications

(35 citation statements)

References 16 publications

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“…The great difference between the costs per day of hospitalization compared to stay at home (€528.95 versus €80.70 respectively) stands out. González Ramallo et al found that the cost of each episode of hospital at home hospitalization was 80% less than that of hospitalization [21], which is consistent with our series. Some authors have argued that OPAT could reduce health costs mainly due to the reduction of days of hospital stay.…”

Section: Discussionsupporting

confidence: 93%

Continuous infusion of antibiotics using elastomeric pumps in the hospital at home setting

García-Queiruga

Cortizas²,

Alfonsín³

et al. 2021

Rev Esp Quimioter

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Introduction. To describe the avoided costs and to analyze the effectiveness of intravenous antibiotic treatment in continuous perfusion in patients at Hospital at Home Units (HHU) administered using elastomeric infusion pumps (EIP) prepared in a Hospital Pharmacy Service (HPS). Materials and methods. Retrospective observational study of the number and type of EIP prepared in the HPS and of the treated patients. Study period: January 2017-December2018. Analyzed data: demographic data of patients, location of infection, responsible microorganism, medication and type of EIP, dose and duration of treatment and its effectiveness in terms of cure or non-cure or patient’s death. Economic valuation considering: costs of EIP, nursing time needed for preparation and cost of HHU care. Results. A total of 1,688 EIP to treat 102 patients resulted in 106 episodes of outpatient treatment of parenteral antibiotic therapy (OPAT) for 1,409 days, thereby avoiding 1,409 days of hospital admission. A total of 59.8% of the patients were men and the mean age was 70.5 ± 17 years. A 31.1% and 68.9% of the cases were empirical and pathogen-directed treatments, respectively. The most used antimicrobials were piperacillin/tazobactam (42.7%), ceftazidime (24.5%), meropenem (19.8%), ceftolozane/tazobactam (2.8%), and cloxacillin (1.9%). Mean duration of treatment was 13.29 ± 8.60 days. Location of infection: respiratory (42.5%), urinary (17.9%), skin and soft tissue (12.3%), bacteraemia (11.3%), osteomyelitis (7.5%), abdominal (3.8%) and 4.7% in other locations. The cure rate was 84%. Total avoided cost: 580,788.28€ in the 24 months studied. Conclusion. This program represents very important economic savings for the health system, and the effectiveness of the antibiotic treatment has not been compromised.

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Section: Discussionsupporting

confidence: 93%

Continuous infusion of antibiotics using elastomeric pumps in the hospital at home setting

García-Queiruga

Cortizas²,

Alfonsín³

et al. 2021

Rev Esp Quimioter

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“…Additionally, the information regarding to PPJI was limited. Thirteen publications mentioned treatment of bone and joint infections (Table 7[9-11,13-15,17,18,20,21,23,25-28]). Of those, only two defined the affected bones or joints in detail.…”

Section: Discussionmentioning

confidence: 99%

Cost-analysis of inpatient and outpatient parenteral antimicrobial therapy in orthopaedics: A systematic literature review

Boese¹,

Lechler²,

Frink³

et al. 2019

WJCC

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BACKGROUND Increasing numbers of total joint arthroplasties and consecutive revision surgery are associated with the risk of periprosthetic joint infections (PPJI). Treatment of PPJI is complex and associated with immense socio-economic burden. One treatment aspect is parenteral antiinfective therapy, which usually requires an inpatient setting [Inpatient parenteral antibiotic therapy (IPAT)]. An alternative is outpatient parenteral treatment [Outpatient parenteral antibiotic therapy (OPAT)]. To conduct a health economic cost-benefit analysis of OPAT, a detailed cost analysis of IPAT and OPAT is required. So far, there is a lack of knowledge on the health economic effects of IPAT and OPAT for PPJI. AIM To review an economic comparison of IPAT and OPAT. METHODS A systematic literature review was performed through Medline following the PRISMA guidelines. RESULTS Of 619 identified studies, 174 included information of interest and 21 studies were included for quantitative analysis of OPAT and IPAT costs. Except for one study, all showed relevant cost savings for OPAT compared to IPAT. Costs for IPAT were between 1.10 to 17.34 times higher than those for OPAT. CONCLUSION There are only few reports on OPAT for PPJI. Detailed analyses to support economic or clinical guidelines are therefore limited. There is good clinical evidence supporting economic benefits of OPAT, but more high quality studies are needed for PPJI.

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“…The results showed savings as a consequence of the activation of the OPAT service between £32.9 million and £6.2 million. González-Ramallo and colleagues33 assessed direct medical cost associated with a hospital at home OPAT in a multicentre retrospective evaluation in Spain. The results show an 80% decrease of costs through OPAT compared with inpatient management.…”

Section: Discussionmentioning

confidence: 99%

Organisational and financial consequences of the early discharge of patients treated for acute bacterial skin and skin structure infection and osteomyelitis in infectious disease departments in Greece, Italy and Spain: a scenario analysis

et al. 2019

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ObjectiveThe aim of the analysis is to assess the organisational and economic consequences of adopting an early discharge strategy for the treatment of acute bacterial skin and skin structure infection (ABSSSI) and osteomyelitis within infectious disease departments.SettingInfectious disease departments in Greece, Italy and Spain.ParticipantsNo patients were involved in the analysis performed.InterventionsAn analytic framework was developed to consider two alternative scenarios: standard hospitalisation care or an early discharge strategy for patients hospitalised due to ABSSSI and osteomyelitis, from the perspective of the National Health Services of Greece, Italy and Spain. The variables considered were: the number of annual hospitalisations eligible for early discharge, the antibiotic treatments considered (ie, oral antibiotics and intravenous long-acting antibiotics), diagnosis-related group (DRG) reimbursements, number of days of hospitalisation, incidence and costs of hospital-acquired infections, additional follow-up visits and intravenous administrations. Data were based on published literature and expert opinions.Primary and secondary outcome measuresNumber of days of hospitalisation avoided and direct medical costs avoided.ResultsThe total number of days of hospitalisation avoided on a yearly basis would be between 2216 and 5595 in Greece (−8/−21 hospital beds), between 15 848 and 38 444 in Italy (−57/−135 hospital beds) and between 7529 and 23 520 in Spain (−27/−85 hospital beds). From an economic perspective, the impact of the early discharge scenario is a reduction between €45 036 and €149 552 in Greece, a reduction between €182 132 and €437 990 in Italy and a reduction between €292 284 and €884 035 in Spain.ConclusionsThe early discharge strategy presented would have a positive organisational impact on National Health Services, leading to potential savings in beds, and to a reduction of hospital-acquired infections and costs.

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Costs of outpatient parenteral antimicrobial therapy (OPAT) administered by Hospital at Home units in Spain

Cited by 37 publications

References 16 publications

Continuous infusion of antibiotics using elastomeric pumps in the hospital at home setting

Continuous infusion of antibiotics using elastomeric pumps in the hospital at home setting

Cost-analysis of inpatient and outpatient parenteral antimicrobial therapy in orthopaedics: A systematic literature review

Organisational and financial consequences of the early discharge of patients treated for acute bacterial skin and skin structure infection and osteomyelitis in infectious disease departments in Greece, Italy and Spain: a scenario analysis

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