Impact of Fluid Choice in Systemic Inflammatory Response Syndrome Patients on Hospital Cost Savings.

Autor: Laplante S; Montreal, Canada., Makhija DU; Baxter Healthcare Corporation, One Baxter Parkway, Deerfield, IL, 60015, USA. dilip_makhija@baxter.com., Munson SH; Boston Strategic Partners, Inc., 4 Wellington Street, Suite 3, Boston, MA, 02118, USA., Khangulov VS; Boston Strategic Partners, Inc., 4 Wellington Street, Suite 3, Boston, MA, 02118, USA., Peyerl FW; Boston Strategic Partners, Inc., 4 Wellington Street, Suite 3, Boston, MA, 02118, USA., Paluszkiewicz SM; Boston Strategic Partners, Inc., 4 Wellington Street, Suite 3, Boston, MA, 02118, USA., Ravindranath AJ; Boston Strategic Partners, Inc., 4 Wellington Street, Suite 3, Boston, MA, 02118, USA., Schermer CR; Department of Surgery, Advocate Medical Group, Downers Grove, IL, 60515, USA.
Jazyk: angličtina
Zdroj: PharmacoEconomics - open [Pharmacoecon Open] 2018 Sep; Vol. 2 (3), pp. 325-335.
DOI: 10.1007/s41669-017-0055-y
Abstrakt: Background: There is growing evidence of the benefits of intravenous fluid therapy with balanced crystalloids over 0.9% 'normal' saline. This analysis evaluated the economic impact of increasing usage of a calcium-free balanced crystalloid solution (BAL) in patients with systemic inflammatory response syndrome (SIRS) on an annual hospital budget.
Methods: An Excel ® -based economic model was developed to estimate costs associated with increased BAL usage (i.e., use in a greater proportion of patients), from the US hospital perspective, over a 5-year time horizon. Clinical inputs were based on the results of a retrospective Electronic Health Record (EHR) database analysis identifying significantly fewer complications among SIRS patients receiving predominantly BAL versus saline. Complication-associated costs, adjusted to 2015, were obtained from published reports. Scenario analyses examined cost impacts for hospitals of various sizes, with different BAL adoption levels and rates.
Results: Base-case scenario analysis (300-bed hospital, 80% occupancy, current and year 5 BAL usage in 5 and 75% of SIRS patients, respectively, exponential year-over-year adoption) showed year 1 hospital savings of US$29,232 and cumulative 5-year savings of US$1.16M. Cumulative 5-year pharmacy savings were US$172,641. Scenario analyses demonstrated increasing cumulative 5-year savings with increasing hospital size, year 5 BAL usage in greater proportions of patients, and rapid/early BAL adoption.
Conclusions: Increased BAL usage represents an opportunity for hospitals and pharmacy departments to reduce complication-related costs associated with managing SIRS patients. The model suggests that savings could be expected across a range of scenarios, likely benefiting hospitals of various sizes and with different adoption capabilities.
Databáze: MEDLINE
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