Assessment of Outpatient and Inpatient Antibiotic Treatment Patterns and Health Care Costs of Patients with Complicated Urinary Tract Infections

2015 ◽  
Vol 37 (9) ◽  
pp. 2037-2047 ◽  
Author(s):  
Ralph M. Turner ◽  
Bingcao Wu ◽  
Kenneth Lawrence ◽  
Judith Hackett ◽  
Sudeep Karve ◽  
...  
Keyword(s):  
Health Care ◽  
Urinary Tract ◽  
Antibiotic Treatment ◽  
Health Care Costs ◽  
Urinary Tract Infections ◽  
Treatment Patterns ◽  
Tract Infections ◽  
Care Costs

scholarly journals Longitudinal, Nationwide, Cohort Study to Assess Incidence, Outcomes, and Costs Associated with Complicated Urinary Tract Infection

2019 ◽  
Author(s):  
Joseph J Carreno ◽  
Iris M Tam ◽  
Juliana L Meyers ◽  
Elizabeth Esterberg ◽  
Sean D Candrilli ◽  
...  
Keyword(s):  
Health Care ◽  
Urinary Tract ◽  
Health Care Costs ◽  
Complicated Urinary Tract Infection ◽  
Limited Data ◽  
Inclusion Criteria ◽  
The Us ◽  
New Treatment ◽  
Tract Infections ◽  
Care Costs

AbstractAbstract Introduction Complicated urinary tract infections (cUTI) are common infections. Despite their frequency, limited data are available on the incidence and healthcare burden associated with cUTIs. This study details the epidemiology and 30-day health care resource utilization associated with cUTI in the US. Methods Retrospective study of PharmMetrics Plus database from 1/1/2013 to 12/31/2017. Inclusion criteria: age ≥ 18 years, ICD-9/10 cUTI diagnosis, and continuous enrollment for ≥ 6 months pre- and ≥ 30 days post-index dates. Two mutually exclusive study cohorts for cUTI patients were identified based on the setting of the first observed cUTI diagnosis (inpatient (IP) and outpatient (OP)). Results In total 543,502 adults with cUTI met the inclusion criteria (104,866 IP cohort; 438,636 OP cohort). Mean (SD) age was 48.1 (16.5) years and 68.1% were female. The overall incidence of cUTI was 1.01%, equating to approximately 2,882,195 annual cUTI cases in the US. In the IP cohort, overall median (IQR) 30-day health care costs were $13,028 ($4,855-$26,781). Median (IQR) costs for the initial admission were $9,441 ($2,079-$19,027), with median (IQR) length of stay (LOS) of 4 (3-8) days. Among IP patients, 12,933 (12.3%) had a subsequent readmission. In the OP cohort, median (IQR) 30-day health care costs were $1,531 ($305-$4,998). Of OP patients, 40,457 (9.2%) had a 30-day admission. Conclusions This study demonstrates that the economic burden associated with cUTIs is substantial, especially among patients requiring hospitalization. These findings highlight the need for new treatment approaches and antibiotics that avert hospitalization and reduce LOS.

A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit

2021 ◽  
Vol 41 (2) ◽  
pp. 62-71
Author(s):  
Holly N. Shadle ◽  
Valerie Sabol ◽  
Amanda Smith ◽  
Heather Stafford ◽  
Julie A. Thompson ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Improvement Project ◽  
Health Care Associated Infections ◽  
Tract Infections ◽  
Project Objectives ◽  
Care Costs

Background Catheter-associated urinary tract infections are the second most common health care–associated infections, occurring most frequently in intensive care units. These infections negatively affect patient outcomes and health care costs. Local Problem The targeted institution for this improvement project reported 13 catheter-associated urinary tract infections in 2018, exceeding the hospital’s benchmark of 4 or fewer such events annually. Six of the events occurred in the intensive care unit. Project objectives included a 30% reduction in reported catheter-associated urinary tract infections, 20% reduction in urinary catheter days, and 75% compliance rating in catheter-related documentation in the intensive care unit during the intervention phase. Methods This project used a pre-post design over 2 consecutive 4-month periods. The targeted population was critically ill patients aged 18 and older who were admitted to the intensive care unit. A set of bundled interventions was implemented, including staff education, an electronic daily checklist, and a nurse-driven removal protocol for indwelling urinary catheters. Data were analyzed using mixed statistics, including independent samples t tests and Fisher exact tests. Results No catheter-associated urinary tract infections were reported during the intervention period, reducing the rate by 1.33 per 1000 catheter days. There was a 10.5% increase in catheter days, which was not statistically significant (P = .12). Documentation compliance increased significantly from 50.0% before to 83.3% during the intervention (P = .01). Conclusions This bundled approach shows promise for reducing catheter-associated urinary tract infections in critical care settings. The concept could be adapted for other health care–associated infections.

Hospitalization for urinary tract infections and the quality of preventive health care received by people with spina bifida

2009 ◽  
Vol 2 (3) ◽  
pp. 145-152 ◽  
Author(s):  
Brian S. Armour ◽  
Lijing Ouyang ◽  
Judy Thibadeau ◽  
Scott D. Grosse ◽  
Vincent A. Campbell ◽  
...  
Keyword(s):  
Health Care ◽  
Urinary Tract ◽  
Spina Bifida ◽  
Urinary Tract Infections ◽  
Preventive Health Care ◽  
Preventive Health ◽  
Tract Infections

scholarly journals Antibiotic Treatment Failure and Associated Outcomes Among Adult Patients With Community-Acquired Pneumonia in the Outpatient Setting: A Real-world US Insurance Claims Database Study

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Glenn Tillotson ◽  
Thomas Lodise ◽  
Peter Classi ◽  
Donna Mildvan ◽  
James A McKinnell
Keyword(s):  
Health Care ◽  
Treatment Failure ◽  
Antibiotic Treatment ◽  
Health Care Costs ◽  
Outpatient Setting ◽  
Community Acquired Pneumonia ◽  
Failure Group ◽  
Antibiotic Failure ◽  
Care Costs ◽  
Experienced Treatment

Abstract Background Antibiotic treatment failure is common among patients with community-acquired pneumonia (CAP) who are managed in the outpatient setting and is associated with higher mortality and increased health care costs. This study’s objectives were to quantify the occurrence of antibiotic treatment failure (ATF) and to evaluate clinical and economic outcomes between CAP patients who experienced ATF relative to those who did not. Methods Retrospective analysis of the MarketScan Commercial & Medicare Supplemental Databases was performed, identifying patients ≥18 years old, with a pneumonia diagnosis in the outpatient setting, and who received a fluoroquinolone, macrolides, beta-lactam, or tetracycline. ATF was defined as any of the following events within 30 days of initial antibiotic: antibiotic refill, antibiotic switch, emergency room visit, or hospitalization. Outcomes included 30-day all-cause mortality and CAP-related health care costs. Results During the study period, 251 947 unique patients met inclusion criteria. The mean age was 52.2 years, and 47.7% were male. The majority of patients received a fluoroquinolone (44.4%) or macrolide (43.6%). Overall, 22.1% were classified as ATFs. Among 18–64-year-old patients, 21.2% experienced treatment failure, compared with 25.7% in those >65 years old. All-cause mortality was greater in the antibiotic failure group relative to the non–antibiotic failure group (18.1% vs 4.6%, respectively), and the differences in 30-day mortality between antibiotic failure groups increased as a function of age. Mean 30-day CAP-related health care costs were also higher in the patients who experienced treatment failure relative to those who did not ($2140 vs $54, respectively). Conclusions Treatment failure and poor outcomes from outpatient CAP are common with current guideline-concordant CAP therapies. Improvements in clinical management programs and therapeutic options are needed.

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