{"text_format":"1","workbook":"xlsx","n_sheets":5,"sheets":["Cover sheet","OPAT Cost calculator","Results","Assumptions","SHTG result"],"not_rendered":{"charts":0,"images":1,"macros":1,"external_links":0,"defined_names":13,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Cover sheet","index":0,"n_rows":44,"n_cols":6,"rows_kept":44,"cut":false,"hidden":false,"merged":[]}
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[]
[]
[]
[]
[null,null,null,null,"Outpatient Parenteral Antimicrobial Therapy (OPAT)"]
[]
[]
[]
[null,null,null,null,"Cost calculator"]
[]
[null,null,null,null,"The OPAT cost calculator has been developed as a supplement to SHTG's OPAT advice published in February 2021.  The calculator enables service planners to estimate the relative cost impact of OPAT in their local area."]
[null,null,null,null,"The model does not capture all variability within OPAT services and thus the results are intend to help inform decision making only."]
[]
[null,null,null,null,"The cost calculator incorporates six key health conditions treated using OPAT: "]
[null,null,null,null,null,"Skin and soft tissue infections (SSTI)"]
[null,null,null,null,null,"Orthopaedic infections (bone and joint)"]
[null,null,null,null,null,"Diabetic foot infections"]
[null,null,null,null,null,"Complex urinary tract infections (UTIs)"]
[null,null,null,null,null,"Bronchiectasis "]
[null,null,null,null,null,"Intra-abdominal infections "]
[]
[null,null,null,null,"For each condition, the calculator allows for up to five different models of OPAT care to be inlcuded:"]
[null,null,null,null,null,"Daily visits to OPAT clinic "]
[null,null,null,null,null,"Daily home visits by a specialist nurse"]
[null,null,null,null,null,"Self-administration by bolus IV"]
[null,null,null,null,null,"Self-administration with elastomeric device (CIVI -continuous IV infusion)"]
[null,null,null,null,null,"Self-administration with elastomeric device (CIVI -continuous IV infusion) with clinic visits for change of elastomeric device "]
[null,null,null,null,null,"Elastomeric device (CIVI -continuous IV infusion) with daily home visits by specialist nurse"]
[null,null,null,null,null,"Single dose of lipoglycopeptide (SSTI - only)"]
[null,null,null,null,null,"Oral therapy "]
[]
[null,null,null,null,"The costs of OPAT provision will vary according to health conditions and the specific model of OPAT care chosen locally.  The calculator allows the user to define the health condition, model of care and number/proportion of treatment episodes.  "]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,"Developed by the Scottish Health Technologies Group (SHTG)"]
[]
[null,null,null,null,"Last updated: 27/06/2023"]

{"sheet":"OPAT Cost calculator","index":1,"n_rows":31,"n_cols":24,"rows_kept":31,"cut":false,"hidden":false,"merged":[]}
[null,"Step 1: Select all conditions managed by your service (cells C9 to H9).  You may need to 'enable macros'. The model will not work unless a condition is specified.",null,null,null,null,null,null,null,null,null,null,null,null,null,"Lists "]
[null,"Step 2: Specify the annual number of episodes treated for each selected condition (cells C11 to H11).  The model will not work unless the number of episodes is chosen.",null,null,null,null,null,null,null,null,null,null,null,null,null,"Condition ","Model of care - All ","Select ",{"$f":"P4","v":"Skin and soft tissue infection (SSTI)"},{"$f":"P5","v":"Orthopaedic - Bone and Joint"},{"$f":"P6","v":"Diabetic foot "},{"$f":"P7","v":"Complex UTI"},{"$f":"P8","v":"Bronchiectasis "},{"$f":"P9","v":"Intra-abdominal infection"}]
[null,"Step 3: Select all care models available for each condition in your service.",null,null,null,null,null,null,null,null,null,null,null,null,null,"Select ","Select ",null,"Select ","Select ","Select ","Select ","Select ","Select "]
[null,"Step 4: Specify the OPAT model proportion of use for each condition. For example: Daily visits to OPAT clinic = 50%; Specialist nurse daily home visits = 50%.",null,null,null,null,null,null,null,null,null,null,null,null,null,"Skin and soft tissue infection (SSTI)","Daily visits to OPAT clinic ",null,{"$f":"Q4","v":"Daily visits to OPAT clinic "},{"$f":"S4","v":"Daily visits to OPAT clinic "},{"$f":"T4","v":"Daily visits to OPAT clinic "},{"$f":"U4","v":"Daily visits to OPAT clinic "},{"$f":"Q11","v":"Specialist nurse daily home visits (CIVI)"},{"$f":"T4","v":"Daily visits to OPAT clinic "}]
[null,"Step 5: Click the 'Calculate' button below.",null,null,null,null,null,null,null,null,null,null,null,null,null,"Orthopaedic - Bone and Joint","Specialist nurse daily home visits ",null,"Specialist nurse daily home visits ","Specialist nurse daily home visits ","Specialist nurse daily home visits ","Specialist nurse daily home visits ",{"$f":"Q6","v":"Self-administration - bolus IV"},"Specialist nurse daily home visits "]
[null,"Click 'Default settings' to start again.",null,null,null,null,null,null,null,null,null,null,null,null,null,"Diabetic foot ","Self-administration - bolus IV",null,"Self-administration - bolus IV",{"$f":"Q6","v":"Self-administration - bolus IV"},{"$f":"Q6","v":"Self-administration - bolus IV"},{"$f":"Q6","v":"Self-administration - bolus IV"},{"$f":"Q7","v":"Self-administration - elastomeric device"},{"$f":"Q6","v":"Self-administration - bolus IV"}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Complex UTI","Self-administration - elastomeric device",null,{"$f":"Q8","v":"CIVI as an outpatient (elastomeric device)"},{"$f":"Q7","v":"Self-administration - elastomeric device"},{"$f":"Q7","v":"Self-administration - elastomeric device"},null,{"$f":"Q8","v":"CIVI as an outpatient (elastomeric device)"},{"$f":"Q7","v":"Self-administration - elastomeric device"}]
[null,null,"Condition 1","Condition 2","Condition 3","Condition 4","Condition 5","Condition 6",null,null,null,null,null,null,null,"Bronchiectasis ","CIVI as an outpatient (elastomeric device)",null,{"$f":"Q9","v":"Single dose lipoglycopeptide"},{"$f":"Q10","v":"Supervised oral therapy "},{"$f":"Q10","v":"Supervised oral therapy "},null,null,{"$f":"Q8","v":"CIVI as an outpatient (elastomeric device)"}]
[null,null,"Select","Select","Select","Select","Select","Select",null,null,null,null,null,null,null,"Intra-abdominal infection","Single dose lipoglycopeptide"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Supervised oral therapy "]
[null,"Annual number of episodes ",0,0,0,0,0,0,null,null,null,null,null,null,null,null,"Specialist nurse daily home visits (CIVI)"]
[]
[null,"Model of OPAT care delivery 1","Select","Select","Select","Select","Select","Select"]
[null,"Proportion of treatment episodes ",0,0,0,0,0,0]
[null,"Cost per day ",0,0,0,0,0,0]
[]
[null,"Model of OPAT care delivery 2","Select","Select","Select","Select","Select","Select"]
[null,"Proportion of treatment episodes ",0,0,0,0,0,0]
[null,"Cost per day ",0,0,0,0,0,0]
[]
[null,"Model of OPAT care delivery 3","Select","Select","Select","Select","Select","Select"]
[null,"Proportion of treatment episodes",0,0,0,0,0,0]
[null,"Cost per day ",0,0,0,0,0,0]
[]
[null,"Model of OPAT care delivery 4","Select","Select","Select","Select","Select","Select"]
[null,"Proportion of treatment episodes ",0,0,0,0,0,0]
[null,"Cost per day ",0,0,0,0,0,0]
[]
[null,"Model of OPAT care delivery 5","Select","Select","Select","Select","Select","Select"]
[null,"Proportion of patients treated ",0,0,0,0,0,0]
[null,"Cost per day ",0,0,0,0,0,0]

{"sheet":"Results","index":2,"n_rows":30,"n_cols":8,"rows_kept":30,"cut":false,"hidden":false,"merged":[[24,5,24,6]]}
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[]
[]
[null,null,"Condition 1","Condition 2","Condition 3","Condition 4","Condition 5","Condition 6"]
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[null,"Cost per day in OPAT (PER PATIENT)",{"$f":"'OPAT Cost calculator'!C14*'OPAT Cost calculator'!C15+'OPAT Cost calculator'!C18*'OPAT Cost calculator'!C19+'OPAT Cost calculator'!C22*'OPAT Cost calculator'!C23+'OPAT Cost calculator'!C26*'OPAT Cost calculator'!C27+'OPAT Cost calculator'!C31*'OPAT Cost calculator'!C30","v":0},{"$f":"'OPAT Cost calculator'!D14*'OPAT Cost calculator'!D15+'OPAT Cost calculator'!D18*'OPAT Cost calculator'!D19+'OPAT Cost calculator'!D22*'OPAT Cost calculator'!D23+'OPAT Cost calculator'!D26*'OPAT Cost calculator'!D27+'OPAT Cost calculator'!D31*'OPAT Cost calculator'!D30","v":0},{"$f":"'OPAT Cost calculator'!E14*'OPAT Cost calculator'!E15+'OPAT Cost calculator'!E18*'OPAT Cost calculator'!E19+'OPAT Cost calculator'!E22*'OPAT Cost calculator'!E23+'OPAT Cost calculator'!E26*'OPAT Cost calculator'!E27+'OPAT Cost calculator'!E31*'OPAT Cost calculator'!E30","v":0},{"$f":"'OPAT Cost calculator'!F14*'OPAT Cost calculator'!F15+'OPAT Cost calculator'!F18*'OPAT Cost calculator'!F19+'OPAT Cost calculator'!F22*'OPAT Cost calculator'!F23+'OPAT Cost calculator'!F26*'OPAT Cost calculator'!F27+'OPAT Cost calculator'!F31*'OPAT Cost calculator'!F30","v":0},{"$f":"'OPAT Cost calculator'!G14*'OPAT Cost calculator'!G15+'OPAT Cost calculator'!G18*'OPAT Cost calculator'!G19+'OPAT Cost calculator'!G22*'OPAT Cost calculator'!G23+'OPAT Cost calculator'!G26*'OPAT Cost calculator'!G27+'OPAT Cost calculator'!G31*'OPAT Cost calculator'!G30","v":0},{"$f":"'OPAT Cost calculator'!H14*'OPAT Cost calculator'!H15+'OPAT Cost calculator'!H18*'OPAT Cost calculator'!H19+'OPAT Cost calculator'!H22*'OPAT Cost calculator'!H23+'OPAT Cost calculator'!H26*'OPAT Cost calculator'!H27+'OPAT Cost calculator'!H31*'OPAT Cost calculator'!H30","v":0}]
[null,"Cost per treatment episode (OPAT)",0,0,0,0,0,0]
[null,"Total cost  - OPAT",{"$f":"C7*'OPAT Cost calculator'!C11","v":0},{"$f":"D7*'OPAT Cost calculator'!D11","v":0},{"$f":"E7*'OPAT Cost calculator'!E11","v":0},{"$f":"F7*'OPAT Cost calculator'!F11","v":0},{"$f":"G7*'OPAT Cost calculator'!G11","v":0},{"$f":"H7*'OPAT Cost calculator'!H11","v":0}]
[]
[null,"Cost per bed day ",0,0,0,0,0,0]
[null,"Cost per treatment episode (inpatient)",0,0,0,0,0,0]
[null,"Total cost - Inpatient care",{"$f":"C11*'OPAT Cost calculator'!C11","v":0},{"$f":"D11*'OPAT Cost calculator'!D11","v":0},{"$f":"E11*'OPAT Cost calculator'!E11","v":0},{"$f":"F11*'OPAT Cost calculator'!F11","v":0},{"$f":"G11*'OPAT Cost calculator'!G11","v":0},{"$f":"H11*'OPAT Cost calculator'!H11","v":0}]
[]
[null,"Cost savings (per day)",{"$f":"C6-C10","v":0},{"$f":"D6-D10","v":0},0,0,0,0]
[null,"Cost savings (per treatment episode) ",{"$f":"C7-C11","v":0},0,0,0,0,0]
[null,"Cost savings (total)",0,0,0,0,0,0]
[]
[null,"Treatment duration in OPAT (bed days)",0,0,0,0,0,0]
[null,"Total bed days saved ",{"$f":"C18*'OPAT Cost calculator'!C11","v":0},{"$f":"D18*'OPAT Cost calculator'!D11","v":0},{"$f":"E18*'OPAT Cost calculator'!E11","v":0},{"$f":"F18*'OPAT Cost calculator'!F11","v":0},{"$f":"G18*'OPAT Cost calculator'!G11","v":0},{"$f":"H18*'OPAT Cost calculator'!H11","v":0}]
[null,null,"User input ","User input ","User input ","User input ","User input ","User input "]
[null,"User-defined duration of treatment - OPAT",0,0,0,0,0,0]
[null,"User-defined duration of treatment - Inpatient ",0,0,0,0,0,0]
[]
[]
[null,null,null,null,null,"User-defined duration of treatment "]
[]
[null,null,"Total cost of OPAT service ",{"$f":"SUM(C8:H8)","v":0},null,"Total cost of OPAT service ",{"$f":"C21*C6*'OPAT Cost calculator'!C11 +D6*D21*'OPAT Cost calculator'!D11+E6*E21*'OPAT Cost calculator'!E11+F6*F21*'OPAT Cost calculator'!F11+G6*G21*'OPAT Cost calculator'!G11+H6*H21*'OPAT Cost calculator'!H11","v":0}]
[null,null,"Total cost of inpatient care ",{"$f":"SUM(C12:H12)","v":0},null,"Total cost of inpatient care ",{"$f":"C10*C22*'OPAT Cost calculator'!C11+D10*D22*'OPAT Cost calculator'!D11+E10*E22*'OPAT Cost calculator'!E11+F10*F22*'OPAT Cost calculator'!F11+G10*G22*'OPAT Cost calculator'!G11+H10*H22*'OPAT Cost calculator'!H11","v":0}]
[null,null,"Total cost savings",{"$f":"SUM(C16:H16)","v":0},null,"Total cost savings",{"$f":"G27-G28","v":0}]
[null,null,"Total bed days saved",{"$f":"SUM(C19:H19)","v":0},null,"Total bed days saved",{"$f":"SUM(C22:H22)*SUM('OPAT Cost calculator'!C11:H11)","v":0}]

{"sheet":"Assumptions","index":3,"n_rows":30,"n_cols":15,"rows_kept":30,"cut":false,"hidden":false,"merged":[[12,3,12,4]]}
[]
[null,"All assumptions and model inputs can be found in  Appendix  4  of the SHTG Recommendation document found here:  https://shtg.scot/our-advice/outpatient-parenteral-antimicrobial-therapy-opat/ "]
[]
[null,"This cost calculator includes the following updates:"]
[null,"1. Cost of staff updated to year 2021 : https://www.pssru.ac.uk/project-pages/unit-costs/unit-costs-of-health-and-social-care-2021/ "]
[null,"2.The cost of Linezolid was obtained from BNF instead of Emit: https://bnf.nice.org.uk/drugs/linezolid/ "]
[null,"3. The rate of rehospitalization is condition-specific and based on NORS data"]
[]
[]
[]
[null,"Important model inputs:"]
[null,"Table 1: Mean duration of treatment in OPAT and a 95% confidence interval"]
[null,"Condition ","Mean number of treatment days ","95% CI "]
[null,"SSTI",6.85,4.66,10.42]
[null,"Bone-Joint",24.77,18.93,32.42]
[null,"Diabetic foot",23.94,15.05,38.46]
[null,"Complex UTI",7,4.0999999999999996,14.25]
[null,"Bronchiectasis",10.9,8.2799999999999994,14.17]
[null,"Intra-abdominal",19.89,11.74,34.29]
[]
[null,"Table 2: Distribution of medicines "]
[null,"Condition","Medicine option 1","%","Medicine option 2","%","Medicine option 3","%","Medicine option 4","%","Medicine option 5","%","Medicine option 6","%","Source"]
[null,"SSTI (IV)","Ceftriaxone ",0.75,"Teicoplanin",0.1,"Daptomycin",0.05,"Flucloxacillin",0.05,"Dalbavancin",0.05,null,null,"Expert opinion"]
[null,"Bone-Joint (IV)","Ceftriaxone ",0.6,"Teicoplanin",0.3,"Ertapenem ",0.1,null,null,null,null,null,null,"Expert opinion"]
[null,"Bone-Joint (oral)","Ciprofloxacin/Rifampicin",0.25,"Levofloxacin/Rifampicin",0.125,"Co-trimoxazole/Rifampacin",0.125,"Clindamycin/Rifampicin",0.125,"Linezolid/ciprofloxacin",0.125,"Linezolid",0.25,"Expert opinion"]
[null,"Diabetic foot (IV)","Ceftriaxone ",0.45,"Teicoplanin",0.1,"Ertapenem ",0.45,null,null,null,null,null,null,"Expert opinion"]
[null,"Diabetic foot (oral)","Clindamycin/Doxycycline",0.25,"Clindamycin/Co-trimoxazole",0.125,"Clindamycin/Ciprofloxacin",0.125,"Linezolid/ciprofloxacin",0.125,"Ciprofloxacin/Doxycycline",0.25,"Levofloxacin/Doxycycline",0.125,"Expert opinion"]
[null,"Complex UTI (IV)","Ertapenem ",0.9,"Temocillin ",0.1,null,null,null,null,null,null,null,null,"Expert opinion"]
[null,"Bronchiectasis (IV)","Ceftazidime",0.7,"Pip-Taz",0.15,"Meropenem ",0.15,null,null,null,null,null,null,"Expert opinion"]
[null,"Intra-abdominal (IV)","Ertapenem",0.75,"Pip-Taz",0.25,null,null,null,null,null,null,null,null,"Expert opinion"]

{"sheet":"SHTG result","index":4,"n_rows":28,"n_cols":9,"rows_kept":28,"cut":false,"hidden":true,"merged":[[21,3,21,4]]}
[null,"Base case results "]
[null,"Model of care ",null,"SSTI","Orthopeadic -Bone and joint ","Diabetic foot","Complex UTI","Bronchiactasis ","Intra-abdominal "]
[null,"Inpatient stay","Cost per day ",386.94071288909743,297.80516474247452,297.80516474247452,300.57072488646486,297.2130106007067,320.89199922638051]
[null,"OPAT - once daily visits","Cost per day ",104.49897559275544,105.54699811559318,121.54535861249209,114.22316495511653,"N/A",131.19304462241814]
[null,"OPAT - specialist nurse daily home visit","Cost per day ",138.34332656277306,138.85191614494329,154.07938142829622,148.17924723359755,216.94061494993218,163.84175903602599]
[null,"OPAT - self-administration - IV bolus","Cost per day ",91.43468926153237,81.104506839591636,97.850765592658163,107.48281640177115,139.41408062919982,115.94212832202284]
[null,"OPAT - self-administration - elastomeric device","Cost per day ",98.658242496294378,99.985850474539589,111.8200302770923,"N/A",159.99142193868948,157.77146539985426]
[null,"OPAT - elastomeric device (continuous infusion;outpatient)","Cost per day ",129.21493351288785,"N/A","N/A","N/A",184.86932465376876,186.38799967628498]
[null,"OPAT - one-off dose  dalbavancin ","Cost per day ",1279.4040395676002,"N/A","N/A","N/A","N/A","N/A"]
[null,"OPAT - supervised oral therapies - 100%","Cost per day ","N/A",73.075292333652555,83.937474318144666,"N/A","N/A","N/A"]
[]
[]
[null,"Cost of inpatient stay per bed day "]
[null,"Condition","Cost ","Notes","Source "]
[null,"SSTI",2476.4205624902202,"Elective and long-term non-elective excess bed day, HD21D-H","NHS England Reference costs,2019"]
[null,"Orthopeadic ",8278.9835798407894,"Elective and long-term non-elective excess bed day, HD25D-H, HE81A-C","NHS England Reference costs,2019"]
[null,"Diabetic foot infection ",8427.8861622120294]
[null,"Complex UTI",2103.9950742052501,"Elective and long-term non-elective excess bed day, LA04N-P","NHS England Reference costs,2019"]
[null,"Bronchiactasis ",3269.3431166077698,"Elective and long-term non-elective excess bed day,DZ22K-Q","NHS England Reference costs,2019"]
[null,"Intra-abdominal ",7123.8023828256501,"Elective and long-term non-elective excess bed day, FD01F-S","NHS England Reference costs,2019"]
[]
[null,"Condition ","Mean number of treatment days ","95% CI "]
[null,"SSTI",6.85,4.66,10.42]
[null,"Bone-Joint",24.77,18.93,32.42]
[null,"Diabetic foot",23.94,15.05,38.46]
[null,"Complex UTI",7,4.0999999999999996,14.25]
[null,"Bronchiectasis",10.9,8.2799999999999994,14.17]
[null,"Intra-abdominal",19.89,11.74,34.29]