Patient benefits and economic sustainability of OPAT
Abstract:
Introduction: Healthcare-associated infections (HAIs) represent a significant health and economic problem, with high frequency and severity. The project aims to analyse the existing organisational model in order to maximise value for both patients and healthcare providers through Lean and Value-Based Healthcare (VBHC) methodologies.
Materials and methods: From 2023 to 2024, a Lean programme, OPAT v2.0, was implemented to transfer antibiotic administration from the hospital to patients’ homes, monitoring processes, costs and results using company databases and VBHC analysis. The costs of administration, antibiotic consumption and the economic impact of home care compared to hospital outpatient care were evaluated.
Results: In 2024, 268 personalised administrations were provided to home-based patients, for a total cost of € 107,011 in antibiotics. The estimated cost for home administration ranges from € 112,381.20 to € 243,064.80, while the hospital cost ranges from € 204,328.21 to € 464,442.10. The VBHC analysis showed significant economic savings in the home model compared to the hospital model, although this was limited by the availability of nursing staff and means of transport to patients’ homes. The most commonly used antibiotics were ertapenem, daptomycin and ceftolozane tazobactam, the main choice being linked to the lower number of daily administrations.
Conclusions: The OPAT v2.0 model demonstrates clinical and economic effectiveness, reducing hospital costs and improving quality of care. However, full implementation requires better territorial organisation, with home administration only for non-self-sufficient patients, while self-sufficient patients should be administered at district clinics in order to relieve congestion in hospital clinics.
Reference:
Lacerenza LG, Sposato B, Garofalo C, Bonini P, Campolmi C, Nencioni C, Francardi M, Gepponi A, Spaghetti S, Theodule M, Bechi L, Petrucci E, Meini B. Analisi in ottica Value-based healthcare della somministrazione di antibiotici in setting non ospedaliero: valutazione dei benefici per il paziente e della sostenibilità economica del sistema [Value-Based Healthcare analysis of antibiotic administration in non-hospital settings: assessment of patient benefits and economic sustainability of the system.]. Recenti Prog Med. 2026 Mar;117(3):137-145. Italian. doi: 10.1701/4669.46828. PMID: 41869796.