Tice A D, Poretz D, Cook F, Zinner D, Strauss M J
Infections Limited P. S., Tacoma, Washington, USA.
Clin Infect Dis. 1998 Dec;27(6):1415-21. doi: 10.1086/515028.
A number of studies have documented the safety, efficacy, and cost-effectiveness of outpatient intravenous (i.v.) antibiotic therapy for patients with infectious diseases. Nevertheless, Medicare policy prohibiting coverage of outpatient, self-administered drugs has severely limited access of Medicare patients to ambulatory i.v. therapy, thus forcing them to rely on more costly, impatient hospital care. To test the hypothesis that a new Medicare benefit providing coverage for ambulatory i.v. antibiotic therapy could significantly reduce the program's expenditures for the treatment of infectious diseases (including pneumonia, osteomyelitis, cellulitis, and endocarditis), a cost model was constructed with use of patient care information from the clinical literature as well as clinical experts, Medicare data, and other medical claims databases. The model shows cumulative 5-year savings of nearly $1.5 billion associated with the new Medicare benefit. Policy makers should consider implementing such a benefit.
多项研究记录了门诊静脉注射抗生素疗法对传染病患者的安全性、有效性和成本效益。然而，医疗保险政策禁止承保门诊自行给药的药物，这严重限制了医疗保险患者获得门诊静脉治疗的机会，从而迫使他们依赖成本更高的非门诊医院护理。为了检验一项新的医疗保险福利为门诊静脉抗生素治疗提供保险可以显著降低该计划用于治疗传染病（包括肺炎、骨髓炎、蜂窝织炎和心内膜炎）的支出这一假设，利用临床文献中的患者护理信息以及临床专家、医疗保险数据和其他医疗理赔数据库构建了一个成本模型。该模型显示，新的医疗保险福利在5年内累计节省近15亿美元。政策制定者应考虑实施这样一项福利。
