Sara Jo Bugeja
Clinical benefits and costs of an outpatient parenteral antimicrobial therapy service.
Bugeja, Sara Jo; Stewart, Derek; Vosper, Helen
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.
BUGEJA, S.J., STEWART, D. and VOSPER, H. . Clinical benefits and costs of an outpatient parenteral antimicrobial therapy service. Research in social and administrative pharmacy [online], In Press. 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|
|Deposit Date||Feb 8, 2021|
|Publicly Available Date||Jan 25, 2022|
|Journal||Research in social and administrative pharmacy|
|Peer Reviewed||Peer Reviewed|
|Keywords||Outpatient parenteral antimicrobial therapy; Activity-based costing; Service evaluation; Patient-centred care; Malta|
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