Partnership with detox facility proves beneficial for PWID with bacterial infections
Click Here to Manage Email Alerts
A partnership between a hospital system and a community detoxification facility led to significant reductions in lengths of stay and costs without increasing readmission or mortality rates among people who inject drugs, findings showed.
“The standard practice in our hospital was to keep people who inject drugs (PWID) with serious bacterial infections (SBIs) in the hospital for prolonged periods until they completed their prescribed course of IV antibiotics or left [against medical advice],” Stephanie S. Gelman, MD, an infectious disease specialist in the Intermountain Medical Center’s division of infectious diseases and clinical epidemiology, told Healio. “A new program was created as the result of a collaboration with a community partner to facilitate safe outpatient parenteral antibiotic therapy (OPAT) discharge with an opportunity to engage with drug recovery resources.”
In a recent paper published in Open Forum Infectious Diseases, Gelman and colleagues described the Comprehensive Care of Drug Addiction and Infection (CCDAI) program a partnership between Intermountain Healthcare hospitals and a nonprofit residential detox facility that provided simultaneous drug recovery assistance (DRA) and parenteral antibiotic therapy to PWID with SBIs. The researchers compared outcomes in PWID with SBIs throughout a 1-year postimplementation period in 2018 with outcomes in patients from a historical control period in 2017.
Overall, 87 patients were candidates for the CCDAI program during the implementation period, with 35 participants (40.2%) enrolled in DRA-OPAT and discharged to the detox facility and 16 (45.7%) completing the full OPAT duration. According to the researchers, 51 patients with similar characteristics were identified as the historical control group.
The study showed that the median length of stay was reduced from 22.9 days (inpatient quality indicator [IQI] = 9.8-42.7) to 10.6 days (IQI = 6-17.4) after the program was implemented (P < .0001). Additionally, researchers found that the total median cost per patient decreased from $39,220.90 (IQI = $23,300.71-$82,506.66) before the program was implemented to $27,592.39 (IQI = $18,509.45-48,369.11) after implementation (P < .0001). They saw similar 90-day readmission rates between the groups, (23.5% vs 24.1%), although at 1-year follow-up, all-cause mortality was 7.1% in the preimplementation group vs. 1.2% in the postimplementation group (P = .06).
“Collaboration between hospitals and community partners creates opportunities to provide PWID with safe and resource-efficient OPAT in a nonhospital setting,” Gelman said.
Collapse
Read more about
Click Here to Manage Email Alerts