Cost & Outcomes Comparison of Patients Whose Treatment Began in Infusion Center vs. After Discharge
SAN DIEGO, CA (October 19, 2012) – A retrospective, multicenter review was conducted of eligible patients treated in the POIC from January 1- June 30, 2011, including 30-day follow-up to compare outcomes and costs in a POIC versus treatment after hospital discharge. Clinical success was defined as cured or improved. Clinical success was significantly higher in the POIC group (p < 0.05) than those treated following hospital discharge for both diagnoses. With the UTI group, there was a similar incidence of multidrug resistant organisms (MDRO) and extended spectrum β-lactamase producing organisms. For treatment of UTI, the clinical success in the POIC was 90% with 3% readmission; whereas the clinical success in patients treated post hospital discharge was 80% with 7% readmission. Recurrences of UTI were similar, with no recurrences hospitalized in the POIC group and two (22%) in the post hospital discharge group. For PNA patients, pathogens were similar, although more MDRO were noted in the post hospital discharge group. The clinical success for PNA in the POIC was 95% with 5% readmission; whereas the clinical success in patients treated post hospital discharge was 79% with 9% readmission. Additionally, four out of 34 (12%) of the PNA patients in the post hospital discharge group had recurrences (p < 0.05), three of whom were then readmitted for an average of nine more days. In addition, costs were significantly less (p < 0.001) for the groups initially treated in the POIC. This study demonstrates a possible advantage in primary POIC management of UTI and PNA as compared to use of a POIC for post-discharge completion of therapy, with significant improvement in clinical success and cost of care, as well as a recurrence and readmission reduction for PNA in patients with treatment initiated in the POIC.
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IDWeek 2012 is the first joint annual meeting of the Infectious Diseases Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA), and the Pediatric Infectious Diseases Society (PIDS). With the theme—Advancing Science, Improving Care—IDWeek will feature the latest science and bench-to-bedside approaches in prevention, diagnosis, treatment, and epidemiology of infectious diseases, including HIV, across the lifespan. IDWeek 2012 takes place October 17-21 at the San Diego Convention Center in San Diego, California.
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Lucinda J. Van Anglen, PharmD