Antimicrobial Stewardship Programs (ASP) are recommended to optimize antimicrobial use. Establishing an ASP, however, requires financial investment. The costs of ASPs in children’s hospitals have not been described previously. In this study, we describe the annual costs incurred from ASPs in U.S. children’s hospitals.
An online survey was administered to ASP leaders at freestanding children’s hospitals participating in the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) collaborative between October 2014-February 2015. The survey assessed costs of institutional ASP investment in 4 categories: personnel, equipment, software and other. Hospitals providing salary support as % effort of full time equivalent (FTE) for a physician and/or pharmacist were included in the final analysis. Along with survey responses, salary and fringe data from the American Association of Medical Colleges Faculty survey, National Bureau of Labor Statistics and vendor estimates for equipment and software were used to calculate ASP costs in 2014 US dollars.
Of 32 participants in SHARPS, 29 (71%) hospitals (median bed-size 302, median ASP duration 2 years) completed the survey. 26 had dedicated physician and/or pharmacist FTE and were included in the final analysis. Only 10/26 (38.6%) ASPs had formal business plans. Overall ASP costs varied from $17,000- $388,500 (median $127,200) annually. All 26 ASPs provided support for physicians (FTE range 0.1-0.8, median 0.3), spending $17,000-$134,000 (median $50,300) annually; 22 (85%) provided support for pharmacists (FTE range 0.3-1.5, median 0.5) spending $45,700-152,200 (median $76,100) annually; and 5(19.2%) provided support for data analysts (FTE range 0.2-0.5, median 0.2) spending $29,100 -$72,800 (median $36,400) annually. Few (5/26) purchased software specifically for ASP with median annual costs of $70,000 (range $58,300- $145,000). Few ASPs supported the cost of equipment (6), education/training (4), travel (7) or personnel recruitment (1).
Institutional spending on ASP programs varies substantially across freestanding children’s hospitals. Further work will assess the association of hospital investment with ASP outcomes.
RPSdiagnostics: Consultant , Consulting fee
J. S. Gerber, None
L. Saiman, None
J. Goldman, None
A. L. Hersh, Pfizer: Grant Investigator , Grant recipient and Research grant
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