Infectious Disease

Partnership with detoxification facility proves beneficial for PWID with bacterial infections

December 29, 2021

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The authors do not report any relevant financial information.

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The results showed that a partnership between a hospital system and a community detoxification facility resulted in significant reductions in length of stay and costs without increasing drug-injecting drug re-admission or death rates.

“Standard practice in our hospital has been to keep patients injecting medication (PWID) with Severe Bacterial Infections (SBIs) in the hospital for long periods of time until they have completed their prescribed IV antibiotic treatment or have left the hospital [against medical advice]”Stephanie S. Gelman, MD, an infectious disease specialist in the Department of Infectious Diseases and Clinical Epidemiology at Intermountain Medical Center, told Healio. “As a result of working with a community partner, a new program has been launched to allow safe ambulatory discharge of parenteral antibiotic therapy (OPAT) with the ability to deal with drug recovery resources.”

Person injecting drugs

A hospital system that worked with a community detoxification facility successfully reduced the cost and length of stay for people injecting drugs with severe bacterial infections. Source: Adobe Stock.

In a paper recently published in the Open Forum Infectious Diseases, Gelman and colleagues described the Comprehensive Care of Drug Addiction and Infection (CCDAI) program, a partnership between Intermountain Healthcare hospitals and a nonprofit inpatient detoxification facility that provides simultaneous drug recovery (DRA) assistance and parenteral medication offers antibiotic therapy for PWID with SBIs. The researchers compared the results for PWID with SBIs over a period of one year after implementation in 2018 with results in patients from a historical control period in 2017.

A total of 87 patients were candidates for the CCDAI program during the implementation period, with 35 participants (40.2%) enrolled in DRA-OPAT and discharged to the detoxification facility, and 16 (45.7%) completed the entire OPAT period. According to the researchers, 51 patients with similar characteristics were identified as a historical control group.

The study showed that the median length of stay of 22.9 days (inpatient quality indicator [IQI] = 9.8-42.7) to 10.6 days (IQI = 6-17.4) after completing the program (P <0.0001). In addition, the researchers found that the mean total cost per patient increased from $ 39,220.90 (IQI = $ 23,300.71 to $ 82,506.66) prior to the implementation of the program to $ 27,592.39 (IQI = 18,509.45-48,369, $ 11) after implementation (P <0.0001) decreased. They saw similar 90-day readmission rates between groups (23.5% vs. 24.1%), although all-cause mortality at 1-year follow-up was 7.1% in the pre-implementation group vs. 1.2% in the of the group after implementation was (P = .06).

“The collaboration between hospitals and community partners creates opportunities to provide PWID with safe and resource-efficient OPAT in a non-clinical setting,” said Gelman.

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