The cost-benefit associated with the maturity of the Antimicrobial Stewardship Program versus prematurity in Heart Hospital of Hamad Medical Corporation in Qatar
Background
Evidence suggests that approximately 70% of patients are on antimicrobials, alarmingly half of these prescribed antimicrobials are deemed inappropriate. We evaluated the cost-benefit of the antimicrobial stewardship program (ASP) in the Heart Hospital, Qatar.
Methods
This retrospective study evaluated patients who received antimicrobial medications during the premature (P-ASP) and mature ASP (M-ASP) periods. The P-ASP period was the first 12 months immediately after ASP implementation (Jan-Dec 2016), while M-ASP period was the recent 12 months of ASP implementation (Feb 2020 - Jan 2021). The total economic benefit resulting from ASP maturity was calculated by combining the cost savings and cost avoidance attributed to the service and then subtracting the operational expenses.
Results
A total of 668 patients were included in the study (255 in P-ASP versus 413 in M-ASP). With M-ASP, cost of hospital tests use ‘decreased’ by QAR 1,149 per 100-patient beds per year, cost of ASP personnel ‘decreased’ by QAR 125 per 100-patient beds with the M-ASP, cost of drug use ‘increased’ by QAR 176,848 per 100-patient beds, cost of resistance and hospitalization ‘increased’ by QAR 216,279 per 100-patient beds per year. The overall relative M-ASP cost and benefits are QAR 393,127 and QAR 1,274 per 100-patient beds, respectively, and the net benefit is QAR -391,853 per 100-patient beds. Sensitivity analysis reported negative benefits in 100% of simulated cases (Figure 1). The most contributing factor was the cost of hospitalization stay (Figure 2).
Conclusions
M-ASP was associated with decreased operational and resource costs, but this was outweighed by increased costs of resistance and drug use, which could be due to higher sample size in the M-ASP. Also, varying compliance with preventive measures, such as focusing on limiting patient-to-patient spread of multidrug resistant organisms, which was not addressed in this study, would contribute substantially to wide-ranging improvements in cost reductions.
History
Language
- English
Publisher
Hamad Medical CorporationPublication Year
- 2024
License statement
This Item is licensed under the Creative Commons Attribution 4.0 International License.Institution affiliated with
- Hamad Medical Corporation
- Heart Hospital - HMC
- Qatar University
- Qatar University Health - QU
- College of Pharmacy - QU HEALTH
- Ministry of Public Health