Predictors of Hospital Readmission in Patients Receiving Outpatient Parenteral Antimicrobial Therapy

Abstract

Readmissions while patients received OPAT were common. Therefore, proactive interventions including primary care physician assignment to facilitate follow-up and communication should be implemented to decrease the risk of readmission, particularly in the identified high-risk populations.

Safety and effectiveness of ‘hospital in the home’ and ‘outpatient parenteral antimicrobial therapy’ in different age groups: A systematic review of observational studies

“…Twenty‐six studies published between 1997 and 2016 analysed the safety and effectiveness of OPAT services. This included 3 prospective studies without comparison group and 23 retrospective studies without comparison group . Nine studies were performed in Europe, eight in the USA, two in Australia, two in New Zealand, two in Singapore, one in Canada, one in Saudi Arabia and one in Israel .…”

“…In the study performed by Steinmetz et al, only 30% of the total patients’ data files were reviewed for complications (21%). Similarly, Means et al considered only 144 cases out of 216 when reporting cure rate (70%). Rehm and Longworth evaluated only 52.8% of the total patients treated in the period for outcome.…”

“…Numerous studies assessing the adverse events (AEs) and effectiveness of HITH and OPAT have been performed in many countries including Australia, USA, UK, Spain, France, Singapore, Israel, Canada, Italy, Ireland, New Zealand, Saudi Arabia, Switzerland and Greece . Some studies have analysed the safety of HITH or OPAT for a particular disease or for a particular group including geriatric or paediatric patients …”

Incidence and risk factors for healthcare utilisation among patients discharged on outpatient parenteral antimicrobial therapy

“…In this study of 230 patients receiving OPAT via a PICC, the overall 60-day HCU incidence rate was 27%, in the range found in previous OPAT studies [6, 7, 12, 13]. Yan et al recently conducted a single-center retrospective cohort study of 104 patients discharged on OPAT and reported an all-cause 60-day HCU rate of 43%, 26% of whom were readmitted to the hospital [6].…”

“…Many patients are discharged on OPAT for the treatment of osteomyelitis and endocarditis, and since the recommended treatment for these diagnoses may be greater than four weeks, it is important to evaluate beyond 30 days. Means et al performed a retrospective cohort study and found that 20% of OPAT patients experienced a hospital readmission, although this study did not specify the duration of follow-up [7]. In our study, both inpatient hospital readmissions and ED visits were included in the endpoint as both indicate an exacerbation in a patient’s health status and may represent a failure of OPAT as a step-down approach.…”