Clinical benefits and costs of an outpatient parenteral antimicrobial therapy service.

Bugeja, Sara Jo; Stewart, Derek; Vosper, Helen

Abstract

Background: The enrolment of patients to an outpatient parenteral antimicrobial therapy (OPAT) service can be a means of mitigating financial burdens related to the provision of care and optimisation of hospital bed management. Objective: This study aimed to identify the clinical benefit of the Maltese OPAT service and to quantify the costs incurred to run it. Methods: The study period ran for 156 weeks during 1st October 2016 to 1st October 2019. Patient demographics, infection type, referring care team, antimicrobial agent/s used, type of vascular access device (VAD) available and service completion status (defined as provision of care without re-hospitalisation) were recorded. Time allocated for OPAT service delivery and expenses incurred were collected and an activity-based costing exercise was performed. Results: The patient population who benefited from the service was of 117, 15 of whom used the service twice, for a total of 132 episodes. Patients received 149 antimicrobial treatment courses, with ceftriaxone being the most common single agent used (n = 52, 34.9%). Teicoplanin with ertapenem was the most common regimen selected for combination therapy (n = 9, 52.9%). A total of 23 episodes (17.4%) resulted in a readmission, 6 (30%) of which were because of patient deterioration. The mean service running weekly cost was €455.47/$538.68 and a total of 3287 days of hospital stay were avoided. This effectively illustrates that the OPAT service optimised hospital bed availability without compromising care delivery. Conclusion: The national OPAT service proved to be a safe and effective alternative for patient management to promote patient-centred care without hospitalisation.

Citation

BUGEJA, S.J., STEWART, D. and VOSPER, H. 2021. Clinical benefits and costs of an outpatient parenteral antimicrobial therapy service. Research in social and administrative pharmacy [online], 17(10), pages 1758-1763. Available from: https://doi.org/10.1016/j.sapharm.2021.01.009

• Journal Article Type: Article
• Acceptance Date: Jan 18, 2021
• Online Publication Date: Jan 24, 2021
• Publication Date: Oct 31, 2021
• Deposit Date: Feb 8, 2021
• Publicly Available Date: Jan 25, 2022
• Journal: Research in social and administrative pharmacy
• Print ISSN: 1551-7411
• Electronic ISSN: 1934-8150
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 17
• Issue: 10
• Pages: 1758-1763
• DOI: https://doi.org/10.1016/j.sapharm.2021.01.009
• Keywords: Outpatient parenteral antimicrobial therapy; Activity-based costing; Service evaluation; Patient-centred care; Malta
• Public URL: https://rgu-repository.worktribe.com/output/1187311