Cost-analysis of inpatient and outpatient parenteral antimicrobial therapy in orthopaedics: A systematic literature review

Table 4 Detailed description of costs of outpatient parenteral antibiotic therapy and inpatient parenteral antibiotic therapy depending on available information

ID	First author	Ref.	Cost IPAT	Cost OPAT	Cost-difference	Comment
1	Al Alawi1	[8]	€43152.41 / €50343.67 €143.37/d2	€17261.45 €57.35/d2	€25890.96 €86.02/d2	301 bed days were saved by OPAT. Exact cost reduction not clear in text
2	Antoniskis	[9]	US $234.22/d US $10022.23 /pat	US $69.35/d US $6357.52/pat	US $229.70/d US $3664.71/pat	Historical data/prices from 1977/78. Average day costs calculated
3	Bernard	[10]	US $710/d US $2233945	US $129/d US $360060	US $581/d US $1873885	2.147 patient-days of 39 patients
4	Chapman	[11]	£372.53/d £1502769	£151.79/d £612306	£220.74/d £890,463	Calculation based on 4034 bed-days
5	Connors1	[12]	CAN $1720.70 / d CAN $717530 €1063451.21	CAN $1094/d CAN $120096 €177994.28	CAN $288/d CAN $597434 €884919.24	110 patients with 417 bed-days. Average: 3.8 d with CAN $1094 / case
6	Gonzales	[13]	€4357/pat €518.70/d	€2350/pat €98.30/d	€420.40/d	Very detailed calculation. Methods presented. IPAT for an average of 8.4 days. OPAT included IPAT for readmission within 30 d
7	Gray	[14]			£192635 £662/patient	Simulation of cost analysis based on potentially saved bed days. Calculation include OPAT as well as other treatment changes. 18/429 patients in the calculation would have been eligible for OPAT
8	Grizzard	[15]	US $159.54/d US $101314	US $112.68/d US $29763	US $112.68/d US $71551	Historical data (1988). Cost-Charge Ratio. Additional Homecare-treatment (OPHAT) of center based OPAT and IPAT differentiated. 635 bed days
9	Harrison	[16]	£264 / d £84480	£109.59 / d £35070	£154.41 / d £49,410	Simplified calculation. 320 bed days
10	Heintz	[17]	US $424080 US $658.50/visit			Simplified calculation with relevant limitations. 228 bed days were saved by OPAT
11	Kieran	[18]	€342862	€167.60/d €558912	€-216.050	Prospective study on 60 cases. 1289 bed days saved. Community nurses included in OPAT calculation
12	Lacroix	[19]	€1125/d €335250	€228/d €67943	€897/d €14850/pat €267307	Simulated cost analysis. 298 bed days saved
13	Malone	[20]	US $829/d US $1143.957	US $278848	US $14661/pat US $864997	IPAT costs based on Council of Australian Governments. 1,569 bed days saved
14	Nathwani	[21]	£300 / d £11400 / pat £627000	£1,749.15/pat £96,203.25	£9650.85/pat £530796.75	Three groups: IPAT, OPAT (Teicoplanin) and outpatient oral therapy (Linezolid). Oral group not included
15	Nguyen	[22]	US $1180/d US $556960	US $385/d US $181720	US $795/d US $375240	472 OPAT visits
16	Ruh	[23]	US $7540135.35	US $607583.32	US $6932552.03	Complex cost calculation with multiple factors
17	Seaton	[24]	£13019.57/pat £455685	£6,532.89/pat £228651	£6,487/pat £227034	Three groups: IPAT, OPAT (Teicoplanin) and outpatient oral therapy (Linezolid). Oral group not included. Calculation based on 37 cases
18	Sims	[25]	£250/d £14500/pat	£24/d 1392/pat	£24/d £13108/pat	For two weeks OPAT cost reduction of 2108 £/Pat
19	Theocharis	[26]	€167.50-195.50/d	€164/d €637/pat		Re-admission rates (14.2%) and costs not included in OPAT calculation
20	Wai	[27]	€20728/pat €2901983	€2774/pat €388402	€17954/pat €2513580	Very detailed cost analysis for IPAT and OPAT. Perspectives of payer and hospitals were presented
21	Yong	[28]	US $457/d US $12403/pat	US $278/d US $12736/pat		Includes calculation for opportunity-costs

¹Currency converted to Euro using exchange rates based on the middle of the publication year;

²Calculation simplified based on limited data. IPAT: Inpatient parenteral antibiotic therapy; OPAT: Outpatient parenteral antibiotic therapy.