A cost calculator has been developed as a supplement to SHTG’s 2021 Recommendations on the provision of outpatient parenteral antimicrobial therapy (OPAT) services.
SHTG’s Recommendations included an analysis of the cost of OPAT services and compared these with the equivalent costs of inpatient care. The calculator enables service planners to estimate the relative cost impact of OPAT in their local area.
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.
Notes for the user:
- Health conditions included in the model: skin and soft tissue infections (SSTI); orthopaedic infections (bone and joint); diabetic foot infections; complex urinary tract infections (UTI); bronchiectasis; intra-abdominal infections.
- OPAT care models include: daily visits to OPAT clinic; daily home visits by a specialist nurse; self-administration by bolus IV; self-administration with elastomeric device (CIVI – continuous IV infusion); self-administration with elastomeric device (CIVI) with clinic visits for change of elastomeric device; elastomeric device (CIVI) with daily home visits by a specialist nurse; single dose of lipoglycopeptides (SSTI only); and oral therapy – orthopaedic and diabetic foot infections only.
- The condition-specific duration of a treatment episode is based on average data from the NORS data set (2015-2019). However, the cost model has the functionality to consider user-defined duration of treatment episodes for both OPAT and inpatient care.
- All assumptions used for the estimation of OPAT costs can be found in Appendix 4 of the published SHTG Recommendation for OPAT: https://shtg.scot/our-advice/outpatient-parenteral-antimicrobial-therapy-opat/
- Average data (NORS dataset) were used in this cost calculator. The calculator does not have the granularity to capture all variation in the provision of OPAT care; for example, conditions beyond the six included, changes in the frequency of use and/or types of medicines, or variation in the distance specialist nurses travel to patients’ homes.
What were we asked to look at?
SHTG published recommendations for OPAT in February 2021. Further work was requested to develop a cost calculator; the calculator will enable users to input their own data to estimate the relative cost effectiveness (compared with inpatient management) of OPAT services, and potentially support the scaling up of service provision based on their local needs.
Why is this important?
As stated in the 2021 SHTG recommendations, OPAT should be available to all who need it. The calculator will support OPAT decision making and service development across the UK.
The Scottish Antimicrobial Prescribing Group and British Society for Antimicrobial Chemotherapy