OBJECTIVES: To estimate utilization and costs of in-home intravenous antibiotics treatments for patients following tibia fractures, and to examine risk factors associated with receiving antibiotics treatments post-surgery.

METHODS: This was a retrospective cohort study using data from IBM MarketScan^® Commercial Claims Research Database. Patients with a new tibia fracture diagnosis in either the inpatient or outpatient settings between January 1, 2016 and July 1, 2017 were included. An episode care was defined as having a claim date or prescription coverage within 7 days of each other. Cost and utilization were computed by year and episode and categorized into three categories, total costs, antibiotics costs and in-home antibiotics costs. Multivariable logistic regression was used to assess the association between in-home IV antibiotics care utilization and patient characteristics.

RESULTS: Among total of 6,553 patients, 200 patients received at least one in-home IV antibiotics within one year after tibia fracture diagnosis. For patients receiving in-home IV care, annual average total cost was $43,558, including in-home IV antibiotics cost of $6,584 (15.16%). While patients without in-home IV antibiotics had an annual total cost of $12,784. The average number of episodes per person was 1.95, and average length of an episode was 11.79 days. The average total cost per episode was $4,103, including $1,814 of antibiotics cost.

Compared with patients aged between 18 and 35 years old, patients who were 36 to 50 and 51 to 65 years old were 2.45 and 2.08 times more likely to receive in-home IV antibiotics, respectively. Patients with grade I/II and grade III tibia fractures were 1.97 and 4.01 times more likely to receive in-home IV antibiotics than patients with closed fractures. (All P<0.0001)

CONCLUSIONS: Patients received in-home IV antibiotics after tibia fracture surgery had higher healthcare payments. Age, injury severity and region are associated with in-home IV antibiotics administration.