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Cost-utility analysis of outpatient parenteral antimicrobial therapy (OPAT) in the Brazilian national health system.
Psaltikidis, Eliane Molina; Silva, Everton Nunes da; Moretti, Maria Luiza; Trabasso, Plínio; Stucchi, Raquel Silveira Bello; Aoki, Francisco Hideo; Cardoso, Luís Gustavo de Oliveira; Höfling, Christian Cruz; Bachur, Luis Felipe; Ponchet, Danilo da Fontoura; Colombrini, Maria Rosa Ceccato; Tozzi, Cíntia Soarez; Ramos, Rosana Fins; Costa, Sandra Mara Queiroz; Resende, Mariângela Ribeiro.
Afiliação
  • Psaltikidis EM; a Hospital Epidemiology Department and Health Technology Assessment Department , Clinical Hospital of State University of Campinas , Campinas , Brazil.
  • Silva END; b School of Medical Sciences , State University of Campinas , Campinas , Brazil.
  • Moretti ML; c Faculty of Ceilândia , University of Brasilia , Brasília , Brazil.
  • Trabasso P; d Division of Infectious Diseases, Internal Medicine Department, School of Medical Sciences , State University of Campinas , Campinas , Brazil.
  • Stucchi RSB; e Hospital Epidemiology Department , Clinical Hospital of State University of Campinas , Campinas , Brazil.
  • Aoki FH; d Division of Infectious Diseases, Internal Medicine Department, School of Medical Sciences , State University of Campinas , Campinas , Brazil.
  • Cardoso LGO; e Hospital Epidemiology Department , Clinical Hospital of State University of Campinas , Campinas , Brazil.
  • Höfling CC; d Division of Infectious Diseases, Internal Medicine Department, School of Medical Sciences , State University of Campinas , Campinas , Brazil.
  • Bachur LF; f Day-Hospital , Clinical Hospital of State University of Campinas , Campinas , Brazil.
  • Ponchet DDF; d Division of Infectious Diseases, Internal Medicine Department, School of Medical Sciences , State University of Campinas , Campinas , Brazil.
  • Colombrini MRC; e Hospital Epidemiology Department , Clinical Hospital of State University of Campinas , Campinas , Brazil.
  • Tozzi CS; e Hospital Epidemiology Department , Clinical Hospital of State University of Campinas , Campinas , Brazil.
  • Ramos RF; e Hospital Epidemiology Department , Clinical Hospital of State University of Campinas , Campinas , Brazil.
  • Costa SMQ; f Day-Hospital , Clinical Hospital of State University of Campinas , Campinas , Brazil.
  • Resende MR; f Day-Hospital , Clinical Hospital of State University of Campinas , Campinas , Brazil.
Expert Rev Pharmacoecon Outcomes Res ; 19(3): 341-352, 2019 Jun.
Article em En | MEDLINE | ID: mdl-30362845
BACKGROUND: Outpatient parenteral antimicrobial therapy (OPAT) has been used for decades in different countries to reduce hospitalization rates, with favorable clinical and economic outcomes. This study assesses the cost-utility of OPAT compared to inpatient parenteral antimicrobial therapy (IPAT) from the perspective of a public university hospital and the Brazilian National Health System (Unified Health System -SUS). METHODS: Prospective study with adult patients undergoing OPAT at an infusion center, compared to IPAT. Clinical outcomes and quality-adjusted life year (QALY) were assessed, as well as a micro-costing. Cost-utility analysis from the hospital and SUS perspectives were conducted by means of a decision tree, within a 30-day horizon time. RESULTS: Forty cases of OPAT (1112 days) were included and monitored, with a favorable outcome in 97.50%. OPAT compared to IPAT generated overall savings of 31.86% from the hospital perspective and 26.53% from the SUS perspective. The intervention reduced costs, with an incremental cost-utility ratio of -44,395.68/QALY for the hospital and -48,466.70/QALY for the SUS, with better cost-utility for treatment times greater than 14 days. Sensitivity analysis confirmed the stability of the model. CONCLUSION: Our economic assessment demonstrated that, in the Brazilian context, OPAT is a cost-saving strategy both for hospitals and for the SUS.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Árvores de Decisões / Assistência Ambulatorial / Anti-Infecciosos / Programas Nacionais de Saúde Tipo de estudo: Health_economic_evaluation / Observational_studies / Prognostic_studies Aspecto: Patient_preference Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Expert Rev Pharmacoecon Outcomes Res Assunto da revista: FARMACOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Árvores de Decisões / Assistência Ambulatorial / Anti-Infecciosos / Programas Nacionais de Saúde Tipo de estudo: Health_economic_evaluation / Observational_studies / Prognostic_studies Aspecto: Patient_preference Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Expert Rev Pharmacoecon Outcomes Res Assunto da revista: FARMACOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido