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门诊静脉用抗菌药物治疗在感染病临床实践中的疗效和成本效益分析:土耳其视角。

Efficacy and cost-effectivity analysis of outpatient parenteral antimicrobial therapy unit in infectious disease clinical practices: Turkey perspective.

机构信息

Department of Infectious Disease and Clinical Microbiology, Ankara Numune Education and Research Center, University of Health Science, Ankara, Turkey.

Department of Family Medicine, Baskent University, Ankara, Turkey.

出版信息

Int J Clin Pract. 2021 Jun;75(6):e14147. doi: 10.1111/ijcp.14147. Epub 2021 Mar 17.

DOI:10.1111/ijcp.14147
PMID:33709495
Abstract

BACKGROUND

Outpatient parenteral antimicrobial treatment (OPAT) has become a common treatment modality in developed countries. OPAT units are not widespread in Turkey, and their cost-effectivity analysis has not been studied, yet.

AIMS

To analyze the clinical efficacy and cost-effectiveness of the OPAT unit, based on a 1000-bed teaching hospital.

METHODS

The records of patients, who were treated between October 2013 and December 2017, in an OPAT unit of a tertiary hospital in Ankara, were obtained retrospectively. The cost that would arise if the patients were hospitalized for the same treatment period with the same diagnosis was calculated and compared with the actual treatment cost of the patients in the OPAT unit.

RESULTS

A total of 594 patients who received antimicrobial treatment at the OPAT unit were enrolled. The mean age of the patients was 55.39 ± 16.37 years and 313 (52.7%) were males. Based on the end-of-treatment goals, 98.5% of the patients reached the treatment goal. An indirect cost analysis revealed that the OPAT unit was 487.625 94 TL/129.008 78 $ less costly than inpatient parenteral antibiotic treatment. In other words, OPAT cost was 75% of the equivalent inpatient costs. It was also determined that a total of 7078 bed days and 11.9 bed days per person were saved.

CONCLUSIONS

OPAT units should be expanded increasingly in Turkey. The evaluation together with the health care system conditions in Turkey revealed that the OPAT program is safe, effective, and cost-efficient.

摘要

背景

在发达国家,门诊患者的肠外抗菌治疗(OPAT)已成为一种常见的治疗方式。然而,OPAT 单位在土耳其并不广泛,其成本效益分析尚未进行。

目的

基于一家拥有 1000 张床位的教学医院,分析 OPAT 单位的临床疗效和成本效益。

方法

回顾性收集安卡拉一家三级医院 OPAT 单位 2013 年 10 月至 2017 年 12 月期间接受治疗的患者记录。计算如果这些患者在同一治疗期间因同一诊断住院治疗会产生的费用,并与患者在 OPAT 单位的实际治疗费用进行比较。

结果

共纳入 594 名在 OPAT 单位接受抗菌治疗的患者。患者的平均年龄为 55.39±16.37 岁,其中 313 名(52.7%)为男性。根据治疗结束时的目标,98.5%的患者达到了治疗目标。间接成本分析显示,OPAT 单位的成本比住院患者的肠外抗生素治疗低 487.625 94 土耳其里拉/129.008 78 美元。换句话说,OPAT 成本是等效住院成本的 75%。还确定总共节省了 7078 个床位日和每人 11.9 个床位日。

结论

OPAT 单位应在土耳其得到进一步推广。对该方案在土耳其的评估以及与医疗保健系统状况相结合的评估表明,OPAT 方案安全、有效且具有成本效益。

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