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Estimating the economic impact of a half-day reduction in length of hospital stay among patients with community-acquired pneumonia in the US.
Curr Med Res Opin. 2009 Sep; 25(9):2151-7.CM

Abstract

BACKGROUND

A recent study suggested that levofloxacin significantly reduces the hospital length of stay (LOS), by 0.5 days (p = 0.02), relative to moxifloxacin in patients with community-acquired pneumonia (CAP). The current analysis evaluated the potential economic impact of this half-day reduction in LOS.

METHODS

A cost model was developed to estimate the impact of a half-day reduction in LOS for CAP hospitalizations in the US. CAP incidence, hospitalization rate, and costs were obtained from published studies in PubMed and from publicly available government sources. The average daily cost of hospitalization was estimated for fixed costs, which comprise 59% of total inpatient costs. Costs from prior years were inflated to 2007 US dollars using the consumer price index. A range of cost savings, calculated using inpatient CAP costs from several studies, was extrapolated to the US CAP population.

RESULTS

Using the Centers for Disease Control National Hospital Discharge estimate of 5.3 days LOS for CAP, and an average cost (2007 $US) of $13,009 per CAP hospitalization, a daily fixed cost of $1448 was estimated. The resultant half-day reduction in costs associated with LOS was $724/hospitalization (range $457 to $846/hospitalization). When fixed and variable costs were considered, the estimated savings were $1227.27/episode. The incidence of CAP was estimated to be 1.9% (5.7 million cases/year based on current population census), and the estimated rate of CAP hospitalization was 19.6% (1.1 million annual hospitalizations). At $13,009/CAP-related hospitalization, total fixed inpatient costs of $8.6 billion annually were projected. The half-day reduction in LOS would therefore generate potential annual savings of approximately $813 million (range $513 million to $950 million). When total costs (fixed plus variable) were estimated, the mean savings for a half-day reduction would be approximately $1227/episode (range of $775 to $1434) or $1.37 billion annually in the US CAP population (range of $871 million to $1.6 billion). Limitations include the use of a single study for the estimation of fixed costs but a diversity of sources used for estimates of other variables, and lack of data with respect to the effects on costs of diagnostic-related groups, discounted contracts, and capitated payments.

CONCLUSIONS

A relatively small decrease in LOS in CAP can have a substantial cost impact, with estimated savings of $457 to $846 per episode or $500-$900 million annually. Additional evaluation is warranted for interpreting these cost-savings in the context of current antibiotic prescribing patterns.

Authors+Show Affiliations

Ortho-McNeil Janssen Scientific Affairs LLC, Raritan, NJ 08869, USA. mraut1@omjus.jnj.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19601711

Citation

Raut, M, et al. "Estimating the Economic Impact of a Half-day Reduction in Length of Hospital Stay Among Patients With Community-acquired Pneumonia in the US." Current Medical Research and Opinion, vol. 25, no. 9, 2009, pp. 2151-7.
Raut M, Schein J, Mody S, et al. Estimating the economic impact of a half-day reduction in length of hospital stay among patients with community-acquired pneumonia in the US. Curr Med Res Opin. 2009;25(9):2151-7.
Raut, M., Schein, J., Mody, S., Grant, R., Benson, C., & Olson, W. (2009). Estimating the economic impact of a half-day reduction in length of hospital stay among patients with community-acquired pneumonia in the US. Current Medical Research and Opinion, 25(9), 2151-7. https://doi.org/10.1185/03007990903102743
Raut M, et al. Estimating the Economic Impact of a Half-day Reduction in Length of Hospital Stay Among Patients With Community-acquired Pneumonia in the US. Curr Med Res Opin. 2009;25(9):2151-7. PubMed PMID: 19601711.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Estimating the economic impact of a half-day reduction in length of hospital stay among patients with community-acquired pneumonia in the US. AU - Raut,M, AU - Schein,J, AU - Mody,S, AU - Grant,R, AU - Benson,C, AU - Olson,W, PY - 2009/7/16/entrez PY - 2009/7/16/pubmed PY - 2009/12/16/medline SP - 2151 EP - 7 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 25 IS - 9 N2 - BACKGROUND: A recent study suggested that levofloxacin significantly reduces the hospital length of stay (LOS), by 0.5 days (p = 0.02), relative to moxifloxacin in patients with community-acquired pneumonia (CAP). The current analysis evaluated the potential economic impact of this half-day reduction in LOS. METHODS: A cost model was developed to estimate the impact of a half-day reduction in LOS for CAP hospitalizations in the US. CAP incidence, hospitalization rate, and costs were obtained from published studies in PubMed and from publicly available government sources. The average daily cost of hospitalization was estimated for fixed costs, which comprise 59% of total inpatient costs. Costs from prior years were inflated to 2007 US dollars using the consumer price index. A range of cost savings, calculated using inpatient CAP costs from several studies, was extrapolated to the US CAP population. RESULTS: Using the Centers for Disease Control National Hospital Discharge estimate of 5.3 days LOS for CAP, and an average cost (2007 $US) of $13,009 per CAP hospitalization, a daily fixed cost of $1448 was estimated. The resultant half-day reduction in costs associated with LOS was $724/hospitalization (range $457 to $846/hospitalization). When fixed and variable costs were considered, the estimated savings were $1227.27/episode. The incidence of CAP was estimated to be 1.9% (5.7 million cases/year based on current population census), and the estimated rate of CAP hospitalization was 19.6% (1.1 million annual hospitalizations). At $13,009/CAP-related hospitalization, total fixed inpatient costs of $8.6 billion annually were projected. The half-day reduction in LOS would therefore generate potential annual savings of approximately $813 million (range $513 million to $950 million). When total costs (fixed plus variable) were estimated, the mean savings for a half-day reduction would be approximately $1227/episode (range of $775 to $1434) or $1.37 billion annually in the US CAP population (range of $871 million to $1.6 billion). Limitations include the use of a single study for the estimation of fixed costs but a diversity of sources used for estimates of other variables, and lack of data with respect to the effects on costs of diagnostic-related groups, discounted contracts, and capitated payments. CONCLUSIONS: A relatively small decrease in LOS in CAP can have a substantial cost impact, with estimated savings of $457 to $846 per episode or $500-$900 million annually. Additional evaluation is warranted for interpreting these cost-savings in the context of current antibiotic prescribing patterns. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/19601711/Estimating_the_economic_impact_of_a_half_day_reduction_in_length_of_hospital_stay_among_patients_with_community_acquired_pneumonia_in_the_US_ L2 - https://www.tandfonline.com/doi/full/10.1185/03007990903102743 DB - PRIME DP - Unbound Medicine ER -