Methods: Medical records from pts treated at 12 Infectious Disease (ID) POICs over 2 years from 1/1/2013 to 12/31/2014 were retrospectively reviewed. Data include demographics, therapy characteristics, unplanned 30-day hospital admissions, causes and risk factors. Costs were measured by comparing 30-day readmission rates with average length of stay and inpatient costs derived from national HCUP data for septicemia. Statistical analysis was done by Fisher’s exact and ANOVA tests.
Results: Among 525 septicemia pts, 71 (13.5%) were admitted to the hospital within 30 days of OPAT initiation including 35 for worsening infections, 17 for catheter-associated complications, 9 for new infections, 7 for adverse drug reactions, and 3 for reasons unrelated to diagnosis. Significant risk factors associated with readmissions were 3 or more comorbidities (OR 5.71, p<0.0001), 6-month prior hospitalization (OR 3.58, p<0.0001) and presence of malignancy (OR 1.96, p=0.01). Upon readmission, the average length of hospitalization post OPAT was 8.1 days compared to 11.1 days for national average. POIC-based OPAT of septicemia resulted in a 6.2% lower 30-day readmission rate than the national average of 19.7% (p=0.009). Based on HCUP data on length of stay and costs of the second admission of septicemia, the estimated hospital costs for the 71 OPAT readmissions would be $1.36 million. This compares to $2.72 million based on national average. The lower readmission rate combined with the shorter length of stay generated substantial OPAT cost savings of 50% (p<0.001).
Conclusion: OPAT management and treatment of septicemia in an ID POIC resulted in a significantly lower readmission rate and shorter length of hospital stay following readmission. Costs were 50% lower than national averages with an overall savings of $1.36 million, significantly impacting overall healthcare expenditures.
B. Metzger, Cubist/Merck: Speaker's Bureau , Speaker honorarium
Forest/Actavis: Speaker's Bureau , Speaker honorarium
R. M. Mandel, None
J. R. Bernett, None
H. B. Baker, Cubist/Merck: Speaker's Bureau , Speaker honorarium
A. E. Bacon, III, None
C. P. Schroeder, None
L. J. Van Anglen, None
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