The Economic Value of Rapid AST in Reducing Length of Stay of Septic Patients

Jaskaran Bains
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Abstract

To construct an economic model to estimate the potential length-of-stay cost savings for hospitals which replace conventional antibiotic susceptibility testing (AST) with rapid AST for the sepsis patient population. We used a wide range of academic studies from the medical and economics literature. Relevant studies were identified and weighted based on study methodological rigor, year of publication and geographic proximity of study population. Each flagged study was read in its entirety and screened for relevant data on inputs to the economic model. Studies which included relevant estimates were read again by two authors to confirm the correct estimate. Each component of the model was compiled from a comprehensive literature search identifying key studies in the field and then combining individual estimates from these studies into a weighted average. Implementation of rapid AST in the sepsis patient population can lead to over $1,600 of savings per sepsis case, or 7.3% of total average admission costs, solely in savings from improved length-of-stay (LOS). When scaled to the hospital level, this represents $5.65 million saved per 100,000 total hospital admissions. The magnitude of potential savings suggests that replacing conventional AST with rapid AST could provide a high return on investment for hospital systems.
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快速AST在减少脓毒症患者住院时间中的经济价值
构建一个经济模型,以估计医院在败血症患者群体中以快速AST替代传统抗生素药敏试验(AST)可能节省的住院时间成本。我们使用了医学和经济学文献中广泛的学术研究。根据研究方法的严谨性、发表年份和研究人群的地理邻近性对相关研究进行识别和加权。每个被标记的研究都被完整地阅读,并筛选经济模型输入的相关数据。两位作者再次阅读了包含相关估计的研究,以确认正确的估计。该模型的每个组成部分都是通过对该领域关键研究的全面文献检索而编制的,然后将这些研究的个别估计合并为加权平均值。在脓毒症患者群体中实施快速AST可导致每个脓毒症病例节省超过1,600美元,或平均住院总费用的7.3%,仅节省住院时间(LOS)。如果按比例计算到医院一级,这意味着每10万住院总人数可节省565万美元。潜在节省的规模表明,用快速AST取代传统AST可以为医院系统提供高投资回报。
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