A MODEL TO EVALUATE THE IMPACT OF HOSPITAL-BASED INTERVENTIONS TARGETING FALSE-POSITIVE BLOOD CULTURES ON ECONOMIC AND CLINICAL OUTCOMES
Author(s)
Geisler BP1, Jilg N2, Patton RG3, Pietzsch JB1
1Wing Tech Inc., Menlo Park, CA, USA, 2Massachusetts General Hospital, Boston, MA, USA, 3Magnolia Medical Technologies, Inc., Seattle, WA, USA
Presentation Documents
OBJECTIVES Blood culture contamination (BCC) increases length of stay (LOS) and leads, in some cases, to unnecessary anti-microbial therapy and/or hospital-acquired conditions (HACs). However, the magnitude of the additional LOS, costs to hospitals and society as well as the harm to patients attributable to BCC have not been quantified previously. METHODS A retrospective matched survival analysis was performed involving hospitalized patients with septicemia-compatible symptoms. BCC costs, hospital-acquired conditions (HACs), and potential savings associated with reducing BCCs and HACs were calculated based on the primary LOS data, a modified Delphi process, and published sources. The cost analysis compared standard care to interventions for reducing BCC, and estimated annual economic and clinical consequences for a typical hospital and for the entire U.S. RESULTS Patients with BCC experienced mean prolonged hospital stays of 2.35 days (p=0.0076). Avoiding BCCs would decrease costs by $6,463 ($4,818 from inpatient care, of which 53% was from reduced length of stay, and 26% was from reduced antibiotic use). Annually, in a typical 250- to 400-bed hospital, employing phlebotomists would save $1.3 million and prevent 24 HACs (including 2 C. difficile cases); based on clinical efficacy evidence, using the studied Initial Specimen Diversion Device® (ISDD®) would save $ 1.9 million and prevent 34 HACs (including 3 C. difficile cases). Nationwide, the respective strategies would prevent 69,300 and 102,900 HACs (including 6,000 and 8,900 C. difficile cases) and costs of $5 and $7.5 billion. CONCLUSIONS Costs and clinical burdens associated with false-positive cultures are substantial and can be reduced by available interventions, including phlebotomists and ISDD use.
Conference/Value in Health Info
2019-05, ISPOR 2019, New Orleans, LA, USA
Value in Health, Volume 22, Issue S1 (2019 May)
Code
PIN44
Topic
Economic Evaluation, Medical Technologies
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Cost-comparison, Effectiveness, Utility, Benefit Analysis, Diagnostics & Imaging, Medical Devices
Disease
Infectious Disease (non-vaccine), Multiple Diseases