Propensity score matched analysis of a palliative radiation oncology consult service’s impact on length of stay and total costs during hospitalization.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 162-162
Author(s):  
Sanders Chang ◽  
Peter May ◽  
Nathan Goldstein ◽  
Doran Ricks ◽  
Kenneth Rosenzweig ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Propensity Score ◽  
Bone Metastases ◽  
Radiation Oncology ◽  
Hospital Cost ◽  
Total Hospital Cost ◽  
Service Model ◽  
Advanced Cancer Patients ◽  
Total Hospital ◽  
Palliative Radiation

162 Background: The Palliative Radiation Oncology Consult Service (PROC) was a clinical service model developed in 2013 at Mount Sinai Hospital to provide individualized, goal-directed treatment to advanced cancer patients requiring palliative radiation therapy (PRT). We assessed its impact on length of stay (LOS) and total costs incurred during a hospitalization among patients who underwent PRT for symptomatic bone metastases while in the hospital. Methods: In our observational cohort study, we identified patients who underwent their first PRT course for bone metastases during a hospitalization between 2/2010 and 12/2016. Total costs (direct and indirect costs) during the hospitalization were extracted from the institution’s cost accounting system. Propensity score matching (PSM) was performed against age, Charlson comorbidity index (CCI), gender, race, primary cancer, and health insurance status. Balance across groups was verified by standardized differences before and after PSM. Average treatment effects (ATE) of hospital costs and LOS were calculated from generalized linear models with a γ distribution and log link adjusted by propensity score weights. PRT patients treated before 2013 (before PROC was established) were compared to those treated after 2013 (after PROC was established). Results: In total, 181 patients were included, with 76 treated before and 105 treated after PROC. Before propensity score matching, patients treated prior to PROC’s establishment had a median total hospital cost of $72,787 (range, $5,981-$324,652) and a median LOS of 28 days (range, 2-105); whereas patients treated after PROC had a median total hospital cost of $49,950 ($7,585-$620,943) and a median LOS of 19 days (2-139). After matching, patients had an ATE of -$16,877 total hospital cost (95% CI [-33,250,-504], p = 0.043) and -8.5 days in LOS (95% CI [-13.9,-3.2], p = 0.002). Conclusions: PROC, a clinical service model that integrated principles of palliative care practice within radiation delivery, led to substantial cost-savings and shorter lengths of stay for advanced cancer patients requiring PRT for bone metastases during a hospitalization.

Are There Differences in Hospital Cost Between Patients With Nosocomial Methicillin-ResistantStaphylococcus aureusBloodstream Infection and Those With Methicillin-SusceptibleS. aureusBloodstream Infection?

2009 ◽  
Vol 30 (5) ◽  
pp. 453-460 ◽  
Author(s):  
Debby Ben-David ◽  
Ilya Novikov ◽  
Leonard A. Mermel
Keyword(s):  
Length Of Stay ◽  
Propensity Score ◽  
Hospital Cost ◽  
Methicillin Resistance ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Icu Patients ◽  
The Difference ◽  
The Impact ◽  
Multivariable Adjustment

Objective.To examine the impact of methicillin resistance on in-hospital mortality, length of stay, and hospital cost after the onset of nosocomialStaphylococcus aureusbloodstream infection (BSI).Design.A retrospective cohort study.Setting.A tertiary care hospital in Rhode Island.Patients.A cohort of 182 consecutive patients who developed nosocomial BSI due to methicillin-susceptible and methicillin-resistantS. aureus(MSSA and MRSA, respectively)Results.Patients with MRSA BSI had a significantly longer total length of hospital and intensive care unit (ICU) stay before the onset of BSI and a higher average daily cost. Compared with ICU patients with MSSA BSI, those with MRSA BSI had a higher median total hospital cost ($42,137 vs $113,852), higher hospital cost after infection ($17,603 vs $51,492), and greater length of stay after infection (10.5 vs 20.5 days). After multivariable adjustment, ICU patients with MRSA BSI had significantly increased total hospital cost, hospital cost after infection, and length of stay after infection. However, using a propensity score approach, we found that, among ICU patients, the difference in cost after infection and the difference in length of stay after infection for MRSA, compared with MSSA BSI, were not significant. The differences among non-ICU patients who developed MRSA or MSSA BSI were not significant after multivariable adjustment or by propensity score.Conclusions.On the basis of propensity score, we found that methicillin resistance did not independently increase hospital cost or length of stay after onset ofS. aureusBSI. We believe that use of a propensity score on a comparable subset of patients may be a better method than multivariable adjustment for assessing the impact of methicillin resistance in cohort studies.

scholarly journals 49 Rooming-In to Treat Neonatal Abstinence Syndrome

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e20-e21
Author(s):  
Shalea Piteau ◽  
Meera Vyas ◽  
Peter Papadakos
Keyword(s):  
At Risk ◽  
Length Of Stay ◽  
Breast Feeding ◽  
Hospital Cost ◽  
Community Hospital ◽  
Neonatal Abstinence Syndrome ◽  
Total Hospital Cost ◽  
Abstinence Syndrome ◽  
Feeding Rates ◽  
Total Hospital

Abstract Background Ontario has been facing a steady rise in the number of individuals abusing narcotics. Newly implemented rooming-in programs in Ontario have allowed infants of opioid-dependent mothers to stay in the same room as their mother while the infant continues to be monitored for signs of neonatal abstinence syndrome (NAS). Objectives To retroactively review the impact of a rooming-in program for babies at risk of NAS on the need for pharmacologic treatment and length of stay in one community hospital site in Belleville, Ontario. Design/Methods Belleville General Hospital developed a rooming-in program for newborns at risk of NAS in July 2015. Prior to its inception, the standard of care was to admit these infants to the special care nursery for monitoring and treatment. Charts were reviewed to collect data on infants born to mothers using opioids in the 24 months prior to (July 2013 – June 2015) and after (July 2015 – June 2017) the implementation of our program. The two groups were compared for the primary outcomes studied, including the number of babies started on morphine and length of stay in hospital. Secondary outcomes were also examined, including breast feeding rates, resource intensity weight, and total hospital cost. Results Rooming-in is associated with a reduction in the need for treatment with morphine, shorter length of stay in hospital, improved breast feeding rates, and lower total hospital cost. Conclusion Our study demonstrates that rooming-in programs for babies born to mothers using opioids have benefits in terms of quality of care and health care resource utilization. These findings add to the existing literature on NAS that rooming-in can be successfully implemented in a community hospital.

scholarly journals Total hospital cost, length of stay, and complications between simultaneous and staged bilateral total hip arthroplasty

Medicine ◽  
2019 ◽  
Vol 98 (11) ◽  
pp. e14687 ◽  
Author(s):  
Zhen Tan ◽  
Guorui Cao ◽  
Guanglin Wang ◽  
Zongke Zhou ◽  
Fuxing Pei
Keyword(s):  
Total Hip Arthroplasty ◽  
Length Of Stay ◽  
Hip Arthroplasty ◽  
Hospital Cost ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Total Hip

Clinical and Economic Outcomes Following Full or Partial ACCP Recommended Prophylaxis in Cancer Patients at Risk of Venous Thromboembolism

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 169-169
Author(s):  
Alpesh Amin ◽  
Jay Lin ◽  
Guiping Yang ◽  
Steve Stemkowski
Keyword(s):  
At Risk ◽  
Venous Thromboembolism ◽  
Length Of Stay ◽  
Cancer Patients ◽  
Hospital Cost ◽  
Mortality Rates ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Vte Prophylaxis ◽  
Prophylaxis Group

Abstract Background: As hospitalized cancer patients are at high risk of venous thromboembolism (VTE), evidence-based guidelines recommend VTE prophylaxis in this population. However, although VTE prophylaxis is frequently provided to at-risk medical and surgical cancer patients, it often fails to meet the criteria for best practice recommendations. As few data are available on the impact of inappropriate prophylaxis on clinical outcomes, we compare the safety and efficacy of fully appropriate or partially appropriate VTE prophylaxis in cancer patients using data from a large hospital administrative database. Methods: Discharges from the Premier Perspective database (Jan 02–Dec 06) with a principal diagnosis of cancer, age ≥40 years, length of stay ≥6 days, and receiving some form of VTE prophylaxis, were included in the analysis. Discharges were excluded if they were transferred from another acute care facility or had any contraindications to VTE prophylaxis. Discharges were divided into two groups: full prophylaxis, receiving ACCP-recommended prophylaxis for a sufficient duration (length of stay minus 2 days; minimum 3 days); partial prophylaxis, receiving some form of prophylaxis that was not recommended by the ACCP guidelines, or receiving a guideline-recommended prophylaxis type, but for an insufficient duration. VTE, readmission, bleeding, mortality rates, and total hospital costs were collected and compared between groups using multivariate regression modelling. Results: Among the 83,794 eligible discharges, the full prophylaxis group (n = 13,387, 16%) had a lower in-hospital VTE rate than the partial prophylaxis (n = 70,407, 84%) group (0.8% vs. 2.9%; odds ratio [OR] 3.09, 95% confidence intervals [CI] 2.51–3.80). Similarly, in-hospital mortality rates were lower in the full prophylaxis group (2.6% vs. 4.2%; OR 1.48, 95% CI 1.29–1.69). No major bleeding events were observed in either group, potentially due to the miscoding of these events. The mean total hospital cost was higher for patients receiving partial prophylaxis ($17,128) than full prophylaxis ($15,284). Conclusion: US cancer patients receiving partial prophylaxis have a higher risk of VTE and mortality than patients receiving full guideline-recommended prophylaxis, leading to a higher total hospital cost. It is important that individual hospitals improve the use of full prophylaxis to reduce both the clinical and economic burden posed by VTE. Disclosures: Amin: sanofi-aventis: Consultancy, Financial and editorial support for this publication was provided by sanofi-aventis US, Inc., Honoraria. Lin:sanofi-aventis: Employment. Yang:sanofi-aventis: employee of Premier Inc which has received funding to perform this research from sanofi-aventis. Stemkowski:sanofi-aventis: employee of Premier Inc which has received funding to perform this research from sanofi-aventis.

A palliative radiation oncology consult service’s impact on care of advanced cancer patients with symptomatic bone metastases.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 110-110
Author(s):  
Sanders Chang ◽  
Cardinale B. Smith ◽  
R. Sean Morrison ◽  
Kenneth Rosenzweig ◽  
Kavita Vyas Dharmarajan
Keyword(s):  
Palliative Care ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Radiation Oncology ◽  
Cancer Type ◽  
Advanced Cancer Patients ◽  
Palliative Radiation ◽  
The Impact ◽  
Pain Improvement

110 Background: Single-fraction and ≤ 5 fraction radiation treatment (SF-RT and Hypo-RT, respectively) is underutilized despite strong evidence regarding its efficacy in symptom management. Established in 2013, the Palliative Radiation Oncology Consult Service (PROC) is a specialty service designed to provide individualized, efficient treatment for advanced cancer patients by a radiation oncology team with a dedicated palliative care focus. We assessed the impact of this new model of care on use of SF-RT, hypo-RT, pain improvement, palliative care utilization, and hospitalization among patients treated with palliative radiation (PRT) for painful bone metastases. Methods: We searched electronic charts of advanced cancer patients who had PRT for symptomatic bone mets from Dec 2010 to April 2015, extracting PRT details, demographics, cancer type, pain pre- and 1 month post-PRT, comorbidities (summarized using Charlson comorbidity index [CCI]), palliative care consults, and hospitalization. Comparisons were made before and after PROC using chi-square or t-tests. Multivariable logistic regression estimated the likelihood of SF-RT or hypo-RT, controlling for age, gender, cancer type, treatment site, and CCI. Results: We identified 334 patients, described in the table below. Patients were more likely to have SF-RT (OR 2.2, 95% CI [1.2-3.8], p = 0.007), or hypo-RT (OR 3.0, 95% CI [1.8-4.7], p < 0.001) after establishment of PROC. Conclusions: Establishment of a PROC service nearly doubled utilization of SF-RT and hypo-RT while maintaining pain improvement, and was associated with an increased use of palliative care consult services, decreased inpatient PRT use, and decreased length of stay. A dedicated service combining palliative care principles and radiation oncology improved quality of palliative cancer care. [Table: see text]

scholarly journals Attributable Costs of Surgical Site Infection and Endometritis after Low Transverse Cesarean Delivery

2010 ◽  
Vol 31 (3) ◽  
pp. 276-282 ◽  
Author(s):  
Margaret A. Olsen ◽  
Anne M. Butler ◽  
Denise M. Willers ◽  
Gilad A. Gross ◽  
Barton H. Hamilton ◽  
...  
Keyword(s):  
Propensity Score ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Hospital Cost ◽  
Total Hospital Cost ◽  
Matched Pairs ◽  
Site Infection ◽  
Total Hospital ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

Background.Accurate data on costs attributable to hospital-acquired infections are needed to determine their economic impact and the cost-benefit of potential preventive strategies.Objective.To determine the attributable costs of surgical site infection (SSI) and endometritis (EMM) after cesarean section by means of 2 different methods.Design.Retrospective cohort.Setting.Barnes-Jewish Hospital, a 1,250-bed academic tertiary care hospital.Patients.There were 1,605 women who underwent low transverse cesarean section from July 1999 through June 2001.Methods.Attributable costs of SSI and EMM were determined by generalized least squares (GLS) and propensity score matched-pairs by means of administrative claims data to define underlying comorbidities and procedures. For the matched-pairs analyses, uninfected control patients were matched to patients with SSI or with EMM on the basis of their propensity to develop infection, and the median difference in costs was calculated.Results.The attributable total hospital cost of SSI calculated by GLS was $3,529 and by propensity score matched-pairs was $2,852. The attributable total hospital cost of EMM calculated by GLS was $3,956 and by propensity score matched-pairs was $3,842. The majority of excess costs were associated with room and board and pharmacy costs.Conclusions.The costs of SSI and EMM were lower than SSI costs reported after more extensive operations. The attributable costs of EMM calculated by the 2 methods were very similar, whereas the costs of SSI calculated by propensity score matched-pairs were lower than the costs calculated by GLS. The difference in costs determined by the 2 methods needs to be considered by investigators who are performing cost analyses of hospital-acquired infections.

scholarly journals Attributable Hospital Cost and Length of Stay Associated with Health Care-Associated Infections Caused by Antibiotic-Resistant Gram-Negative Bacteria

2009 ◽  
Vol 54 (1) ◽  
pp. 109-115 ◽  
Author(s):  
Patrick D. Mauldin ◽  
Cassandra D. Salgado ◽  
Ida Solhøj Hansen ◽  
Darshana T. Durup ◽  
John A. Bosso
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Confidence Interval ◽  
Hospital Cost ◽  
Hospital Costs ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Health Care Associated Infections

ABSTRACT Determination of the attributable hospital cost and length of stay (LOS) are of critical importance for patients, providers, and payers who must make rational and informed decisions about patient care and the allocation of resources. The objective of the present study was to determine the additional total hospital cost and LOS attributable to health care-associated infections (HAIs) caused by antibiotic-resistant, gram-negative (GN) pathogens. A single-center, retrospective, observational comparative cohort study was performed. The study involved 662 patients admitted from 2000 to 2008 who developed HAIs caused by one of following pathogens: Acinetobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., or Pseudomonas spp. The attributable total hospital cost and LOS for HAIs caused by antibiotic-resistant GN pathogens were determined by comparison with the hospital costs and LOS for a control group with HAIs due to antibiotic-susceptible GN pathogens. Statistical analyses were conducted by using univariate and multivariate analyses. Twenty-nine percent of the HAIs were caused by resistant GN pathogens, and almost 16% involved a multidrug-resistant GN pathogen. The additional total hospital cost and LOS attributable to antibiotic-resistant HAIs caused by GN pathogens were 29.3% (P < 0.0001; 95% confidence interval, 16.23 to 42.35) and 23.8% (P = 0.0003; 95% confidence interval, 11.01 to 36.56) higher than those attributable to HAIs caused by antibiotic-susceptible GN pathogens, respectively. Significant covariates in the multivariate analysis were age ≥12 years, pneumonia, intensive care unit stay, and neutropenia. HAIs caused by antibiotic-resistant GN pathogens were associated with significantly higher total hospital costs and increased LOSs compared to those caused by their susceptible counterparts. This information should be used to assess the potential cost-efficacy of interventions aimed at the prevention of such infections.

Total Hospital Costs and Readmission Rate of Patient-Specific Instrument in Total Knee Arthroplasty Patients

2020 ◽  
Author(s):  
Stephen Thomas ◽  
Ankur Patel ◽  
Corey Patrick ◽  
Gary Delhougne
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Hospital Cost ◽  
Readmission Rate ◽  
Hospital Costs ◽  
Patient Specific ◽  
P Value ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Total Knee

AbstractDespite advancements in surgical technique and component design, implant loosening, stiffness, and instability remain leading causes of total knee arthroplasty (TKA) failure. Patient-specific instruments (PSI) aid in surgical precision and in implant positioning and ultimately reduce readmissions and revisions in TKA. The objective of the study was to evaluate total hospital cost and readmission rate at 30, 60, 90, and 365 days in PSI-guided TKA patients. We retrospectively reviewed patients who underwent a primary TKA for osteoarthritis from the Premier Perspective Database between 2014 and 2017 Q2. TKA with PSI patients were identified using appropriate keywords from billing records and compared against patients without PSI. Patients were excluded if they were < 21 years of age; outpatient hospital discharges; evidence of revision TKA; bilateral TKA in same discharge or different discharges. 1:1 propensity score matching was used to control patients, hospital, and clinical characteristics. Generalized Estimating Equation model with appropriate distribution and link function were used to estimate hospital related cost while logistic regression models were used to estimate 30, 60, and 90 days and 1-year readmission rate. The study matched 3,358 TKAs with PSI with TKA without PSI patients. Mean total hospital costs were statistically significantly (p < 0.0001) lower for TKA with PSI ($14,910; 95% confidence interval [CI]: $14,735–$15,087) than TKA without PSI patients ($16,018; 95% CI: $15,826–$16,212). TKA with PSI patients were 31% (odds ratio [OR]: 0.69; 95% CI: 0.51–0.95; p-value = 0.0218) less likely to be readmitted at 30 days; 35% (OR: 0.65; 95% CI: 0.50–0.86; p-value = 0.0022) less likely to be readmitted at 60 days; 32% (OR: 0.68; 95% CI: 0.53–0.88; p-value = 0.0031) less likely to be readmitted at 90 days; 28% (OR: 0.72; 95% CI: 0.60–0.86; p-value = 0.0004) less likely to be readmitted at 365 days than TKA without PSI patients. Hospitals and health care professionals can use retrospective real-world data to make informed decisions on using PSI to reduce hospital cost and readmission rate, and improve outcomes in TKA patients.

Abstract 258: Dabigatran Etexilate is Associated with Shorter Hospital Length of Stay and Lower Hospital Costs Compared to Warfarin in Treatment-Naive, Newly-Diagnosed Nonvalvular Atrial Fibrillation Patients

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Eileen Fonseca ◽  
David R Walker ◽  
Gregory P Hess
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Cost ◽  
Dabigatran Etexilate ◽  
Hospital Costs ◽  
Hospital Length Of Stay ◽  
Total Hospital Cost ◽  
Newly Diagnosed ◽  
Nonvalvular Atrial Fibrillation ◽  
Total Hospital ◽  
Treatment Naïve

Background: Warfarin and dabigatran etexilate (DE) are oral anticoagulants (OAC) used to reduce the risk of stroke among patients with nonvalvular atrial fibrillation (AF). However, DE does not require titration and INR monitoring. This study examined whether hospital length of stay (LOS) and total hospital costs differed between the two therapies among treatment-naive, newly-diagnosed AF patients. Methods: LOS and total hospital costs were evaluated for hospitalizations with a primary or secondary discharge diagnosis of atrial fibrillation (AF) between 1/1/2011-3/31/2012, with DE or warfarin administered during hospitalization, and excluding hospitalizations of patients with valvular AF, previously diagnosed with AF, or previously treated with OAC. Hospitalizations were identified from a Charge Detail Masters database containing 397 qualified hospitals. Samples were propensity score matched using nearest neighbor within a caliper of 0.20 standard deviations of the logit, without replacement and a 2:1 match. Differences in LOS and hospital cost were then estimated using generalized linear models, fitted by generalized estimating equations (clustered by hospital) to account for possible correlation between observations. The hospitalization’s charged amount was multiplied by the hospital’s inpatient cost-to-charge ratio to estimate the total hospital cost. Covariates estimating the propensity score, LOS, and costs included patient age, payer type, CHADS 2 and HAS-BLED scores, use of bridging agents, comorbid conditions, and hospital attributes. As a sensitivity analysis, LOS and costs were estimated with the same parameters and covariates among the raw, unbalanced sample. Results: Matched samples included 1,292 warfarin and 646 DE hospitalizations of treatment-naive, newly diagnosed patients out of 4,619 and 715 hospitalizations, respectively. No covariates used in matching had standardized mean differences > 10% after matching. Two comorbidities (thromboembolism, coronary artery disease) had statistically different distributions after matching (DE: 3% vs. warfarin: 8%, p<0.001 and DE: 40% vs. warfarin: 45%, p=0.048); these were included as model covariates. Among the sample, DE had an estimated 0.7 days shorter stay compared to warfarin (DE: 4.8 days vs. warfarin: 5.5 days, p<0.01) and a $2,031 lower estimated total cost (DE: $14,794 vs warfarin: $16,826, p=0.007). Sensitivity analysis confirmed a shorter DE LOS (DE: 5.5 days vs. warfarin: 6.6 days, delta=1.1 days, p<0.01) and a lower DE hospital cost (DE: $18,362 vs. warfarin: $22,602, delta=$4,240, p<0.01). Conclusions: Among hospitalizations of treatment-naive patients newly diagnosed with nonvalvular AF, the hospitalizations during which DE was administered had a shorter LOS and at least a 12% lower total hospital cost compared to hospitalizations where warfarin was administered.

scholarly journals 1030. Analysis of a Novel Mortality Prediction Rule for Organizing and Guiding Antimicrobial Stewardship Team Activities

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S362-S363
Author(s):  
Curtis D Collins ◽  
Caleb Scheidel ◽  
Christopher J Dietzel ◽  
Lauren R Leeman ◽  
Cheryl A Morrin ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Risk Score ◽  
Antimicrobial Stewardship ◽  
Prediction Rule ◽  
Mortality Prediction ◽  
Audit And Feedback ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Days Of Therapy ◽  
The Impact

Abstract Background Antimicrobial stewardship team (AST) surveillance at our hospital is facilitated by an internally-developed database. In 2013, the database was expanded to incorporate a validated internally-developed prediction rule for patient mortality within 30 days of hospital admission. AST prospective audit and feedback expanded to include all antimicrobials prescribed in patients with the highest risk for mortality determined by risk score. This study describes the impact of an expanded AST review in patients at the highest risk for mortality. Methods This retrospective, observational study analyzed all adult patients with the highest mortality risk score who received antimicrobials not historically captured via AST review. Patients were identified through administrative and AST databases. Study periods were defined as 2011 – Q3 2013 (historical group) and Q4 2013 – 2018 (intervention group). Primary and secondary outcomes were assessed for confounders including demographic data and infection-related diagnoses. Outcomes were assessed using both unweighted and propensity score weighted versions of the t-test or Wilcoxon rank-sum test for continuous variables and the chi-squared test or Fisher’s Exact test for discrete variables. Results A total of 2,852 and 5,460 patients were included in the historical and intervention groups, respectively. After adjusting for demographic and clinical characteristics, there were significant reductions in median antimicrobial duration (5 vs. 4, P = 0.002), antimicrobial days of therapy (7 vs. 7, P = 0.001), length of stay (LOS) (6 vs. 5 days, P = 0.001), intensive care unit (ICU) LOS (3 vs. 2 days, P < 0.001), and total hospital cost ($11,017 vs. $9,134, P < 0.001) in the intervention cohort. There were no significant differences observed in 30-day mortality or 30-day readmissions. Secondary analyses showed significant decreases in fluroquinolone and intravenous vancomycin utilization between cohorts. Conclusion Reductions in antimicrobial use, inpatient and ICU length of stay, and total hospital costs were observed in a cohort of patients following incorporation of a novel mortality prediction rule to guide AST surveillance. Disclosures All authors: No reported disclosures.

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