Cost reduction after introduction of a multidisciplinary infectious disease service at a German university hospital.
BACKGROUND
In 1997 an infectious disease service (IDS) similar to those in the US was established at a university hospital in Munich, Germany.


METHODS
We assessed the economic impact of the new policy by performing a cost comparison analysis. Inpatients with pneumonia, skin infections/cellulitis, urinary tract infections (UTI) and bacteremia/sepsis were assigned to two groups: patients from a 6-month period after the establishment of the IDS (post-IDS group) were compared with similar patients before the implementation of the ID-service (pre-IDS group). Costs of microbiological investigation (MB), antibiotic treatment (AB), clinical imaging (CI), total costs and length of antibiotic therapy were analyzed.


RESULTS
Patients with UTIs in the post-IDS group had 39% fewer MBs (p<0.05) than patients in the pre-IDS group, resulting in a 33% decrease in average MB costs (p<0.05). In the total group, in which subgroups with pneumonia, skin infection and UTI were summarized, the post-IDS group had 37% fewer MBs (p<0.05) resulting in MB cost reductions of 34% (p<0.05). There were no significant differences in expenditures for AB and CI and in the average length of antibiotic therapy.


CONCLUSIONS
This study shows that continuous consultation by an IDS does not increase diagnostic and treatment costs, but results in significant cost reductions.
Wolf
S
S
Medizinische Poliklinik, Ludwig Maximilians University of Munich Hospital, Germany.
Leitritz
L
L
Rupp
C
C
Schlöndorff
D
D
Bogner
J R
JR
D000368:Aged; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy* / Q000191:economics*; D003363:Cost Control; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D017721:Hospital Costs; D006785:Hospitals, University / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy* / Q000191:economics*; D012017:Referral and Consultation; D012874:Skin Diseases, Infectious / Q000188:drug therapy* / Q000191:economics*; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000191:economics*
D000900:Anti-Bacterial Agents