Inpatient and outpatient parenteral antimicrobial therapy: a cost analysis of care transition

Abstract

Objective: To analyse the cost reduction of antimicrobial therapy in the short and long term, during the transition from hospital treatment to home care in the perspective of a healthcare provider. Methods: A selection of antibiotics was carried out comparing the recommendation of the Brazilian Guideline for Parenteral Antimicrobial Therapy (OPAT) and the standardization list of a specialized home care service. Then, were quantifield the direct costs of pharmacological therapy and supportive care for inpatient hospital treatment and home care program based on paid events by the health insurance company in the year 2022. Results: The lowest cost treatment has been associated with the use of Gentamicin, 5 days therapy amounted to R$ 178,98 and 42 days to R$ 532,85 in the home care modality, while in the hospital it ranged from R$ 1.782,08 the treatment for 5 days and R$ 2.337,08 for 42 days. The highest one was the drug Linezolid, which amounted R$ 487,29 for 5 days and R$ 2.620,71 for 42 days with administration at home, and in the hospital it had a cost of R$ 4.118,58 for 5 days and R$ 21.963,68 for 42 days. Aminoglycosides have a profile of little variability in the cost with the increase in days, while other drugs show a significant increase in the cost difference in extended treatment, highlighting Linezolid and Cephalosporins. Conclusion: Antimicrobial therapy proved to be economically favorable for home care in all scenarios, being a strong argument for early dehospitalization.