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PLoS One. 2015 May 8;10(5):e0126106. doi: 10.1371/journal.pone.0126106. eCollection 2015.

Cost-minimization model of a multidisciplinary antibiotic stewardship team based on a successful implementation on a urology ward of an academic hospital.

Author information

1
Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
2
Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Certe Laboratory for Infectious Diseases, Groningen, the Netherlands.
3
Department of Pharmacy, Unit of PharmacoEpidemiology & PharmacoEconomics, University of Groningen, Groningen, the Netherlands.
4
Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, the Netherlands.
5
Department of Pharmacy, Unit of PharmacoEpidemiology & PharmacoEconomics, University of Groningen, Groningen, the Netherlands; Department of Epidemiology, University Medical Center Groningen, Groningen, the Netherlands.

Abstract

BACKGROUND:

In order to stimulate appropriate antimicrobial use and thereby lower the chances of resistance development, an Antibiotic Stewardship Team (A-Team) has been implemented at the University Medical Center Groningen, the Netherlands. Focus of the A-Team was a pro-active day 2 case-audit, which was financially evaluated here to calculate the return on investment from a hospital perspective.

METHODS:

Effects were evaluated by comparing audited patients with a historic cohort with the same diagnosis-related groups. Based upon this evaluation a cost-minimization model was created that can be used to predict the financial effects of a day 2 case-audit. Sensitivity analyses were performed to deal with uncertainties. Finally, the model was used to financially evaluate the A-Team.

RESULTS:

One whole year including 114 patients was evaluated. Implementation costs were calculated to be €17,732, which represent total costs spent to implement this A-Team. For this specific patient group admitted to a urology ward and consulted on day 2 by the A-Team, the model estimated total savings of €60,306 after one year for this single department, leading to a return on investment of 5.9.

CONCLUSIONS:

The implemented multi-disciplinary A-Team performing a day 2 case-audit in the hospital had a positive return on investment caused by a reduced length of stay due to a more appropriate antibiotic therapy. Based on the extensive data analysis, a model of this intervention could be constructed. This model could be used by other institutions, using their own data to estimate the effects of a day 2 case-audit in their hospital.

PMID:
25955494
PMCID:
PMC4425554
DOI:
10.1371/journal.pone.0126106
[Indexed for MEDLINE]
Free PMC Article

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