Cost-Benefit Analysis of Antimicrobial Stewardship Program Maturity in Adult Surgical Ward Settings: A Retrospective Study in Qatar

Background

Implementing Antimicrobial Stewardship (ASP) can result in substantial financial costs. This study aimed to determine the economic impact of ASP maturity in our hospital’s surgical ward settings.

Methods

This retrospective study evaluated patients who received antimicrobials during two periods; the premature ASP period was defined as the first 12 months following the implementation of ASP (May 2015-April 2016). While the mature ASP period was the most recent 12 months of ASP implementation in the hospital (February 2019-January 2020). The total economic benefit of ASP maturity was calculated by combining the cost savings and cost avoidance, minus the operational expenses.3 The cost savings were the reduced cost of therapy associated with an assumed reduction in defined daily dose (DDD) and resource utilization. Cost avoidance was the cost avoided by reducing length of hospitalization and adverse drug events (ADEs). Operational costs included the expenses of the ASP service. Secondary outcomes included ADEs, mortality, length of hospital stay, and hospital readmission.

Results

The study included 108 patients in the premature ASP period and 88 in the mature ASP period. There was an increase in total costs for DDDs and resource utilization, amounting to QAR 163,002. However, in the mature ASP period, the total operational cost was lower compared to the premature ASP period, with a cost saving of QAR 12,477. There were more readmission cases in the premature ASP period (9.3%) compared to the mature period (2.7%). The initial length of hospital stay was longer in the mature ASP, with an average of 20 days, compared to 12 days in the premature ASP. No statistically significant differences were found in terms of mortality or ADEs.

Conclusions

Our findings indicate that while immediate financial benefits may not be evident initially, implementing an ASP system can ultimately result in notable cost reductions over time.