title: Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a Chinese hospital system perspective.
abstract: BACKGROUND
  Cost-impact models have indicated that in the USA, the use of antibiotic stewardship protocols based on procalcitonin (PCT) levels for patients with suspected acute respiratory tract infection results in cost savings. Our objective was to assess the cost impact of adopting PCT testing among patients with acute respiratory infections (ARI) from the perspective of a typical hospital system in urban China.
  
  
  METHODS
  To conduct an economic evaluation of PCT testing versus usual care we built a cost-impact model based on a previously published patient-level meta-analysis data of randomized trials including Chinese sites. The data were adapted to the China setting by applying the results to mean lengths of stay, costs, and practice patterns typically found in China. We estimated the annual ARI visit rate for the typical hospital system (assumed to be 1650 beds) and ARI diagnosis.
  
  
  RESULTS
  In the inpatient setting, the costs of PCT-guided care compared to usual care for a cohort of 16,405 confirmed ARI patients was almost 1.1 million Chinese yuan (CNY), compared to almost 1.8 million CNY for usual care, resulting in net savings of 721,563 CNY to a typical urban Chinese hospital system for 2015. In the ICU and outpatient settings, savings were 250,699 CNY and 2.4 million CNY, respectively. The overall annual net savings of PCT-guided care was nearly 3.4 million CNY.
  
  
  CONCLUSIONS
  Substantial savings are associated with PCT protocols of ARI across common China hospital treatment settings mainly by direct reduction in unnecessary antibiotic utilization.
authors.forename: Ivana
authors.initials: I
authors.lastname: Stojanovic
authors.forename: John E
authors.initials: JE
authors.lastname: Schneider
authors.forename: Long
authors.initials: L
authors.lastname: Wei
authors.forename: Zhan
authors.initials: Z
authors.lastname: Hong
authors.forename: Clara
authors.initials: C
authors.lastname: Keane
authors.forename: Philipp
authors.initials: P
authors.lastname: Schuetz
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D002681:China; D003362:Cost-Benefit Analysis; D004636:Emergency Service, Hospital; D006801:Humans; D007297:Inpatients; D007362:Intensive Care Units; D018803:Models, Economic; D016032:Randomized Controlled Trials as Topic; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000191:economics*
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D002116:Calcitonin