Efficacy and Cost-Effectivity Analysis of Outpatient Parenteral Antimicrobial Therapy Unit in Infectious Disease Clinical Practices: Turkey Perspective

Abstract

Background Outpatient parenteral antimicrobial treatment (OPAT) has become a common treatment modality in developed countries. OPAT units are not widespread in Turkey, and their cost-effectivity analysis has not been studied, yet.

Aims To analyze the clinical efficacy and cost-effectiveness of the OPAT unit, based on a 1000-bed teaching hospital.

Methods The records of patients, who were treated between October 2013 and December 2017, in an OPAT unit of a tertiary hospital in Ankara, were obtained retrospectively. The cost that would arise if the patients were hospitalized for the same treatment period with the same diagnosis was calculated and compared with the actual treatment cost of the patients in the OPAT unit.

Results A total of 594 patients who received antimicrobial treatment at the OPAT unit were enrolled. The mean age of the patients was 55.39 +/- 16.37 years and 313 (52.7%) were males. Based on the end-of-treatment goals, 98.5% of the patients reached the treatment goal. An indirect cost analysis revealed that the OPAT unit was 487.625 94 TL/129.008 78 $ less costly than inpatient parenteral antibiotic treatment. In other words, OPAT cost was 75% of the equivalent inpatient costs. It was also determined that a total of 7078 bed days and 11.9 bed days per person were saved.

Conclusions OPAT units should be expanded increasingly in Turkey. The evaluation together with the health care system conditions in Turkey revealed that the OPAT program is safe, effective, and cost-efficient.