Organisational and financial consequences of the early discharge of patients treated for acute bacterial skin and skin structure infection and osteomyelitis in infectious disease departments in Greece, Italy and Spain: a scenario analysis
Objective The aim of the analysis is to assess the organisational and economic consequences of adopting an early discharge strategy for the treatment of acute bacterial skin and skin structure infection (ABSSSI) and osteomyelitis within infectious disease departments.Setting Infectious disease depar...
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BMJ Publishing Group
2019-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/9/e031356.full |
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| author | Alastair Gray Umberto Restelli Marzia Bonfanti Davide Croce Santiago Grau Symeon Metallidis Santiago Moreno Guillén Valeria Pacelli Giuliano Rizzardini Marco Soro Athanasios Vozikis |
| author_facet | Alastair Gray Umberto Restelli Marzia Bonfanti Davide Croce Santiago Grau Symeon Metallidis Santiago Moreno Guillén Valeria Pacelli Giuliano Rizzardini Marco Soro Athanasios Vozikis |
| author_sort | Alastair Gray |
| collection | DOAJ |
| description | Objective The aim of the analysis is to assess the organisational and economic consequences of adopting an early discharge strategy for the treatment of acute bacterial skin and skin structure infection (ABSSSI) and osteomyelitis within infectious disease departments.Setting Infectious disease departments in Greece, Italy and Spain.Participants No patients were involved in the analysis performed.Interventions An analytic framework was developed to consider two alternative scenarios: standard hospitalisation care or an early discharge strategy for patients hospitalised due to ABSSSI and osteomyelitis, from the perspective of the National Health Services of Greece, Italy and Spain. The variables considered were: the number of annual hospitalisations eligible for early discharge, the antibiotic treatments considered (ie, oral antibiotics and intravenous long-acting antibiotics), diagnosis-related group (DRG) reimbursements, number of days of hospitalisation, incidence and costs of hospital-acquired infections, additional follow-up visits and intravenous administrations. Data were based on published literature and expert opinions.Primary and secondary outcome measures Number of days of hospitalisation avoided and direct medical costs avoided.Results The total number of days of hospitalisation avoided on a yearly basis would be between 2216 and 5595 in Greece (−8/−21 hospital beds), between 15 848 and 38 444 in Italy (−57/−135 hospital beds) and between 7529 and 23 520 in Spain (−27/−85 hospital beds). From an economic perspective, the impact of the early discharge scenario is a reduction between €45 036 and €149 552 in Greece, a reduction between €182 132 and €437 990 in Italy and a reduction between €292 284 and €884 035 in Spain.Conclusions The early discharge strategy presented would have a positive organisational impact on National Health Services, leading to potential savings in beds, and to a reduction of hospital-acquired infections and costs. |
| format | Article |
| id | doaj-art-15b4d60139b3472fb060e7741481b7b5 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-15b4d60139b3472fb060e7741481b7b52024-11-29T23:20:10ZengBMJ Publishing GroupBMJ Open2044-60552019-09-019910.1136/bmjopen-2019-031356Organisational and financial consequences of the early discharge of patients treated for acute bacterial skin and skin structure infection and osteomyelitis in infectious disease departments in Greece, Italy and Spain: a scenario analysisAlastair Gray0Umberto Restelli1Marzia Bonfanti2Davide Croce3Santiago Grau4Symeon Metallidis5Santiago Moreno Guillén6Valeria Pacelli7Giuliano Rizzardini8Marco Soro9Athanasios Vozikis101 Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK1 Center for Health Economics, Social and Health Care Management, LIUC–Università Cattaneo, Castellanza, Italy1 Center for Health Economics, Social and Health Care Management, LIUC–Università Cattaneo, Castellanza, Italy1 Center for Health Economics, Social and Health Care Management, LIUC–Università Cattaneo, Castellanza, Italy3 Pharmacy Department, Hospital del Mar, Barcelona, Spain4 Medical School of Aristotle University of Thessaloniki, Thessaloniki, Greece5 Department of Infectious Diseases, Hospital Ramón y Cajal, University of Alcalá, Madrid, Spain1 Center for Health Economics, Social and Health Care Management, LIUC–Università Cattaneo, Castellanza, ItalyInfectious Diseases, Luigi Sacco University Hospital, Milano, Italy8 Global HEOR, Angelini, Roma, Lazio, Italy9 Laboratory of Health Economics and Management, University of Piraeus, Piraeus, GreeceObjective The aim of the analysis is to assess the organisational and economic consequences of adopting an early discharge strategy for the treatment of acute bacterial skin and skin structure infection (ABSSSI) and osteomyelitis within infectious disease departments.Setting Infectious disease departments in Greece, Italy and Spain.Participants No patients were involved in the analysis performed.Interventions An analytic framework was developed to consider two alternative scenarios: standard hospitalisation care or an early discharge strategy for patients hospitalised due to ABSSSI and osteomyelitis, from the perspective of the National Health Services of Greece, Italy and Spain. The variables considered were: the number of annual hospitalisations eligible for early discharge, the antibiotic treatments considered (ie, oral antibiotics and intravenous long-acting antibiotics), diagnosis-related group (DRG) reimbursements, number of days of hospitalisation, incidence and costs of hospital-acquired infections, additional follow-up visits and intravenous administrations. Data were based on published literature and expert opinions.Primary and secondary outcome measures Number of days of hospitalisation avoided and direct medical costs avoided.Results The total number of days of hospitalisation avoided on a yearly basis would be between 2216 and 5595 in Greece (−8/−21 hospital beds), between 15 848 and 38 444 in Italy (−57/−135 hospital beds) and between 7529 and 23 520 in Spain (−27/−85 hospital beds). From an economic perspective, the impact of the early discharge scenario is a reduction between €45 036 and €149 552 in Greece, a reduction between €182 132 and €437 990 in Italy and a reduction between €292 284 and €884 035 in Spain.Conclusions The early discharge strategy presented would have a positive organisational impact on National Health Services, leading to potential savings in beds, and to a reduction of hospital-acquired infections and costs.https://bmjopen.bmj.com/content/9/9/e031356.full |
| spellingShingle | Alastair Gray Umberto Restelli Marzia Bonfanti Davide Croce Santiago Grau Symeon Metallidis Santiago Moreno Guillén Valeria Pacelli Giuliano Rizzardini Marco Soro Athanasios Vozikis Organisational and financial consequences of the early discharge of patients treated for acute bacterial skin and skin structure infection and osteomyelitis in infectious disease departments in Greece, Italy and Spain: a scenario analysis BMJ Open |
| title | Organisational and financial consequences of the early discharge of patients treated for acute bacterial skin and skin structure infection and osteomyelitis in infectious disease departments in Greece, Italy and Spain: a scenario analysis |
| title_full | Organisational and financial consequences of the early discharge of patients treated for acute bacterial skin and skin structure infection and osteomyelitis in infectious disease departments in Greece, Italy and Spain: a scenario analysis |
| title_fullStr | Organisational and financial consequences of the early discharge of patients treated for acute bacterial skin and skin structure infection and osteomyelitis in infectious disease departments in Greece, Italy and Spain: a scenario analysis |
| title_full_unstemmed | Organisational and financial consequences of the early discharge of patients treated for acute bacterial skin and skin structure infection and osteomyelitis in infectious disease departments in Greece, Italy and Spain: a scenario analysis |
| title_short | Organisational and financial consequences of the early discharge of patients treated for acute bacterial skin and skin structure infection and osteomyelitis in infectious disease departments in Greece, Italy and Spain: a scenario analysis |
| title_sort | organisational and financial consequences of the early discharge of patients treated for acute bacterial skin and skin structure infection and osteomyelitis in infectious disease departments in greece italy and spain a scenario analysis |
| url | https://bmjopen.bmj.com/content/9/9/e031356.full |
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