Robert Gordon University, School of Pharmacy and Life Sciences, Sir Ian Wood Building, Garthdee Road, Aberdeen, AB10 9GJ, UK.
College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
Res Social Adm Pharm. 2021 Oct;17(10):1758-1763. doi: 10.1016/j.sapharm.2021.01.009. Epub 2021 Jan 24.
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.
This study aimed to identify the clinical benefit of the Maltese OPAT service and to quantify the costs incurred to run it.
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.
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.
The national OPAT service proved to be a safe and effective alternative for patient management to promote patient-centred care without hospitalisation.
为门诊患者提供肠外抗菌治疗（OPAT）服务可以减轻与提供治疗和优化医院床位管理相关的经济负担。
本研究旨在确定马耳他 OPAT 服务的临床效益，并量化其运行成本。
研究期间为 2016 年 10 月 1 日至 2019 年 10 月 1 日的 156 周。记录患者人口统计学数据、感染类型、转诊护理团队、使用的抗菌药物/药物、可用的血管通路装置（VAD）类型以及服务完成情况（定义为无需再次住院即可提供治疗）。收集 OPAT 服务交付时间和费用，并进行基于活动的成本核算。
受益于该服务的患者人群为 117 人，其中 15 人两次使用该服务，共计 132 例。患者接受了 149 次抗菌治疗疗程，其中头孢曲松是最常用的单一药物（n=52，34.9%）。替考拉宁联合厄他培南是联合治疗中最常用的方案（n=9，52.9%）。共有 23 例（17.4%）需要再次住院，其中 6 例（30%）是因为患者病情恶化。每周服务运行的平均成本为 455.47 欧元/538.68 美元，共避免了 3287 天的住院治疗。这有效地表明，OPAT 服务在不影响治疗的情况下优化了医院床位的可用性。
国家 OPAT 服务已被证明是一种安全有效的患者管理替代方案，可促进以患者为中心的护理，而无需住院治疗。
