Use of Outpatient Parenteral Antibiotic Therapy in a Health Maintenance Organization

Grizzard, Michael B.; Harris, Gail M.; Karns, Helen

doi:10.1093/clinids/13.supplement_2.s174

Cited by 27 publications

(7 citation statements)

References 14 publications

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“…This may result from the large timeframe of the included studies. For example, studies of Antoniskis et al[9] and Grizzard et al[15] were much older than comparable studies from 2000 to 2017. To allow for a better comparison of studies, therapy costs were calculated for per-day-costs and transformed using the exchange rate for the mid of the year of publication.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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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Section: Discussionmentioning

confidence: 99%

“…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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“…The advent of quinolones probably will not jeopardize out-patient parenteral antibiotic programs. One must be cautious in the use of oral quinolones as monotherapy for Staphylococcus aureus osteomyelitis (12,13). Oral quinolones have not been conclusively shown to be as effective as parenteral antibiotics for acute osteomyelitis due to Gram-positive bacteria.…”

Section: Discussionmentioning

confidence: 99%

Home iv Antibiotic Therapy through a Medical Day Care Unit

Gourdeau

Deschênes

Caron

et al. 1992

Canadian Journal of Infectious Diseases and Medical Microbiolog

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An out-patient parenteral antibiotic therapy program provided through a medical day care unit was evaluated in a tertiary care hospital. From July 11, 1988 to December 31, 1990, 122 patients were treated either on site at the unit or at home with self-administered intravenous antibiotics. In all, 142 courses of parenteral antibiotics (mostly cephalosporins and clindamycin) were given for a total of 124 infections, mostly bone and soft tissue infections (67 of 124, 54%). The duration of out-patient therapy ranged from two to 62 days with a mean duration of 9.4 days if treated at the unit, or 13.2 days in the home care model (1476 patient-days). Vein access was peripheral and catheters remained functional for an average of 4.9 days (range 0.5 to 22 days). Only two patients experienced adverse drug reactions that necessitated modification of treatment. One other case was readmitted to the hospital for surgical debridement. The average cost per patient-day was $66 compared with $375 for in-hospital therapy. This program proved to be safe, efficient, and cost-effective.

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“…In this managed health care environment, Grizzard et al (21) investigated the use of parenteral antibiotic therapy in a health maintenance organization (HMO). Over a 17-month period of time, a total of 46 patients received 64 courses of parenteral antibiotic therapy in an outpatient setting.…”

Section: Recent Researchmentioning

confidence: 99%

Home Drug Infusion Therapy:A Literature Update

Balinsky

Mollin

1998

Int J Technol Assess Health Care

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This paper is a literature review and update of home drug infusion therapy (HDIT) in the United States. It concentrates on cost-effectiveness studies of parenteral antibiotic therapy administered in an outpatient setting. This update is timely because Medicare and other payors are under the pressure of cost containment with respect to this modality. Additionally, managed care is redefining reimbursement programs, which will affect HDIT in the future.

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Use of Outpatient Parenteral Antibiotic Therapy in a Health Maintenance Organization

Cited by 27 publications

References 14 publications

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

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

Home iv Antibiotic Therapy through a Medical Day Care Unit

Home Drug Infusion Therapy:A Literature Update

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