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

The Medicare policy of refusing reimbursement for outpatient intraveno us antibiotic therapy contributes to prolonged inpatient length of sta y and increased hospital costs for Medicare patients. A program for th e 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 ho spital. Forty-eight inpatients with infections that required prolonged intravenous antibiotic therapy were selected for enrollment. Cost sav ings resulting from early discharge in both high- and low-occupancy se ttings were calculated by a unique and accurate system of cost account ing in which both fixed and variable costs were considered. All 48 pat ients were either cured or improved. Of the 11 different infections tr eated, the most common were osteomyelitis (24 patients) and endocardit is (seven patients). Calculated cost savings resulting from early hosp ital discharge of Medicare patients were $335,394 during high occupanc y and $48,368 during low occupancy. The net cost savings to the hospit al were $293,332, or $6111 per patient.