OUTPATIENT INTRAVENOUS ANTIBIOTIC THERAPY IN MEDICARE PATIENTS: COST-SAVINGS ANALYSIS

TLDR

Medicare’s refusal to reimburse outpatient IV antibiotic therapy leads to longer inpatient stays and higher costs for Medicare patients. A program managed by Danbury Hospital’s Infectious Diseases Department enrolled 48 Medicare inpatients needing prolonged IV antibiotics and used a detailed cost‑accounting system to estimate savings from early discharge. All 48 patients were cured or improved, and the program yielded net savings of $293,332 ($6,111 per patient), with $335,394 saved during high occupancy and $48,368 during low occupancy.

Abstract

The Medicare policy of refusing reimbursement for outpatient intravenous antibiotic therapy contributes to prolonged inpatient length of stay and increased hospital costs for Medicare patients. A program for the outpatient management of Medicare patients who required intravenous antibiotic therapy was created under the management of the Infectious Diseases Department of the Danbury Hospital and was paid for by the hospital. Forty-eight inpatients with infections that required prolonged intravenous antibiotic therapy were selected for enrollment. Cost savings resulting from early discharge in both high- and low-occupancy settings were calculated by a unique and accurate system of cost accounting in which both fixed and variable costs were considered. All 48 patients were either cured or improved. Of the 11 different infections treated, the most common were osteomyelitis (24 patients) and endocarditis (seven patients). Calculated cost savings resulting from early hospital discharge of Medicare patients were $335,394 during high occupancy and $48,368 during low occupancy. The net cost savings to the hospital were $293,332, or $6111 per patient.