title: Cost perspectives for outpatient intravenous antimicrobial therapy.
abstract: Intravenous antimicrobial therapy often continues after a patient is discharged from the hospital or it begins in the outpatient setting. Reimbursement for this therapy varies by payer. The United States Outpatient Parenteral Antibiotic Therapy (OPAT) Outcomes Registry is a valuable resource for quantifying cost by payer, as well as for describing practice patterns and adverse events related to intravenous antimicrobial therapy. To describe the reimbursement structure and cost of intravenous vancomycin home care therapy for four different types of payers, a survey of home infusion companies was done. Also surveyed were infusion programs participating in the OPAT Outcomes Registry, representing four different types of payers, to determine the cost of outpatient intravenous therapy. A retrospective cohort study of these infusion programs was conducted to describe practice patterns and to identify adverse events that resulted from intravenous vancomycin. We found that the cost of outpatient therapy was substantial, although nonuniform, across payer types. Alternative outpatient therapies associated with lower risks for adverse events and lower costs should be considered.
authors.affiliation: Outpatient Parenteral Antibiotic Therapy (OPAT), Outcomes Registry, Tacoma, Washington 98402, USA. alantice@idlinks.com
authors.forename: Alan D
authors.initials: AD
authors.lastname: Tice
authors.forename: Pam A
authors.initials: PA
authors.lastname: Hoaglund
authors.forename: Barbara
authors.initials: B
authors.lastname: Nolet
authors.forename: Peggy S
authors.initials: PS
authors.lastname: McKinnon
authors.forename: Essy
authors.initials: E
authors.lastname: Mozaffari
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D015331:Cohort Studies; D003625:Data Collection; D005076:Exanthema / Q000139:chemically induced; D018588:Fee-for-Service Plans / Q000191:economics; D005334:Fever / Q000139:chemically induced; D018718:Home Infusion Therapy / Q000191:economics*; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects / Q000191:economics*; D007263:Infusions, Parenteral / Q000009:adverse effects / Q000191:economics; D007349:Insurance, Health, Reimbursement / Q000191:economics; D007674:Kidney Diseases / Q000139:chemically induced; D008329:Managed Care Programs / Q000191:economics; D008484:Medicaid / Q000191:economics; D006278:Medicare / Q000191:economics; D010818:Practice Patterns, Physicians' / Q000191:economics; D012189:Retrospective Studies; D014481:United States; D014640:Vancomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin