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Artigo Produção Nacional Revisado por pares
BIBTEX RIS

Cost-utility analysis of outpatient parenteral antimicrobial therapy (OPAT) in the Brazilian national health system

2018; Taylor & Francis; Volume: 19; Issue: 3 Linguagem: Inglês

10.1080/14737167.2019.1541404

ISSN

1744-8379

Autores

Eliane Molina Psaltikidis, Everton Nunes da Silva, Maria Luíza Moretti, Plı́nio Trabasso, R.S.B. Stucchi, Francisco Hideo Aoki, Luís Gustavo de Oliveira Cardoso, Christian Cruz Höfling, Luís Felipe Bachur, Danilo da Fontoura Ponchet, Maria Rosa Ceccato Colombrini, Cíntia Soarez Tozzi, Rosana Fins Ramos, Sandra Mara Queiroz Costa, Mariângela Ribeiro Resende,

Tópico(s)

Hemodynamic Monitoring and Therapy

Resumo

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).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.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.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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