Cost reduction after introduction of a multidisciplinary infectious disease service at a German university hospital

Background: In 1997 an infectious disease service (IDS) similar to those in the US was established at a university hospital in Munich, Germany. Patients and Methods: We assessed the economic impact of the new policy by performing a cost comparison ana lysis. inpatients with pneumonia, skin inf ections/ cellulitis, urinary tract infections (UTI) and bacteremia/ sepsis were assigned to two groups: patients from a 6-month period after the estab lishment of the IDS (post-IDS group) were compared with similar patients be fore the implementation of the ID-service (pre-IDS group). Costs of microbi ological investigation (MB), antibiotic treatment (AB), clinical imaging (C I), total costs and length of antibiotic therapy were analyzed. Results: Patients with UTls in the post-IDS group had 39% fewer MBs (p < 0. 05) than patients in the pre-IDS group, resulting in a 33% decrease in aver age MB costs (p < 0.05), in the total group, in which subgroups with pneumo nia, skin infection and UTI were summarized, the post-IDS group had 37% few er MBs (p < 0.05) resulting in MB cost reductions of 34% (p < 0.05). There were no significant differences in expenditures for AB and CI and in the av erage length of antibiotic therapy. Conclusion: This study shows that continuous consultation by an IDS does no t increase diagnostic and treatment costs, but results in significant cost reductions.