Self-Administered Outpatient Antimicrobial Infusion by Uninsured Patients Discharged from a Safety-Net Hospital: A Propensity-Score-Balanced Retrospective Cohort Study

PLoS Medicine

Volumn 12, Issue 12, 2015, Pages

  Bhavan, Kavita P ^a,b   Brown, L Steven ^b   Haley, Robert W ^a,b  

^a EAST TEXAS MEDICAL CENTER   (United States)

^b PARKLAND HEALTH AND HOSPITAL SYSTEM   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIBIOTIC AGENT; ANTIINFECTIVE AGENT;

ADOLESCENT; ADULT; AGED; ANTIMICROBIAL THERAPY; ARTICLE; BACTEREMIA; BONE AND JOINT INFECTIONS; CENTRAL NERVOUS SYSTEM INFECTION; COHORT ANALYSIS; DRUG SELF ADMINISTRATION; FEMALE; FOLLOW UP; FUNDING; HEALTH CARE UTILIZATION; HEALTH SERVICE; HOSPITAL DISCHARGE; HOSPITAL PATIENT; HOSPITAL READMISSION; HUMAN; LOWEST INCOME GROUP; MAJOR CLINICAL STUDY; MALE; MEDICALLY UNINSURED; MIDDLE AGED; MORTALITY; OUTCOME ASSESSMENT; OUTPATIENT DEPARTMENT; PROPENSITY SCORE; PROPORTIONAL HAZARDS MODEL; RETROSPECTIVE STUDY; SAFETY NET HOSPITAL; SELF ADMINISTERED OUTPATIENT PARENTERAL ANTIMICROBIAL THERAPY; SKIN INFECTION; URINARY TRACT INFECTION; OUTPATIENT; PARENTERAL DRUG ADMINISTRATION; PROSPECTIVE STUDY; STATISTICS AND NUMERICAL DATA; TEXAS; VERY ELDERLY; YOUNG ADULT;

ADOLESCENT; ADULT; AGED; AGED, 80 AND OVER; ANTI-INFECTIVE AGENTS; FEMALE; HUMANS; INFUSIONS, PARENTERAL; MALE; MEDICALLY UNINSURED; MIDDLE AGED; OUTPATIENTS; PROPENSITY SCORE; PROSPECTIVE STUDIES; RETROSPECTIVE STUDIES; SAFETY-NET PROVIDERS; SELF ADMINISTRATION; TEXAS; YOUNG ADULT;

EID: 84953746722     PISSN: 15491277     EISSN: 15491676     Source Type: Journal    
DOI: 10.1371/journal.pmed.1001922     Document Type: Article

References (32)

1. Bor DH, Woolhandler S, Nardin R, Brusch J, Himmelstein DU, (2013) Infective endocarditis in the U.S., 1998–2009: a nationwide study. PLoS ONE 8: e60033. doi: 10.1371/journal.pone.0060033 23527296
2. Lipsky BA, Weigelt JA, Gupta V, Killian A, Peng MM, (2007) Skin, soft tissue, bone, and joint infections in hospitalized patients: epidemiology and microbiological, clinical, and economic outcomes. Infect Control Hosp Epidemiol 28: 1290–1298. doi: 10.1007/s00125-010-1672-5 17926281
3. Eisenberg JM, Kitz DS, (1986) Savings from outpatient antibiotic therapy for osteomyelitis. Economic analysis of a therapeutic strategy. JAMA 255: 1584–1588. doi: 10.1001/jama.1986.03370120062024 3951094
4. Institute of Medicine Committee on the Changing Market, Managed Care, and the Future Viability of Safety Net Providers (2000) America’s health care safety net: intact but endangered. Washington (District of Columbia): National Academies Press.
5. Cunningham PJ, Bazzoli GJ, Katz A, (2008) Caught in the competitive crossfire: safety-net providers balance margin and mission in a profit-driven health care market. Health Aff (Millwood) 27: w374–w382. doi: 10.1377/hlthaff.27.5.w374
6. Gilbert DN, Dworkin RJ, Raber SR, Leggett JE, (1997) Outpatient parenteral antimicrobial-drug therapy. N Engl J Med 337: 829–838. doi: 10.1056/NEJM199709183371207 9297114
7. Paladino JA, Poretz D, (2010) Outpatient parenteral antimicrobial therapy today. Clin Infect Dis 51 (Suppl): 198–208. doi: 10.1086/653520
8. Muldoon EG, Snydman DR, Penland EC, Allison GM, (2013) Are we ready for an outpatient parenteral antimicrobial therapy bundle? A critical appraisal of the evidence. Clin Infect Dis 57: 419–424. doi: 10.1093/cid/cit211 23572486
9. Tice AD, Rehm SJ, Dalovisio JR, Bradley JS, Martinelli LP, et al. (2004) Practice guidelines for outpatient parenteral antimicrobial therapy. IDSA guidelines. Clin Infect Dis 38: 1651–1672. doi: 10.1086/420939 15227610
10. Matthews PC, Conlon CP, Berendt AR, Kayley J, Jefferies L, et al. (2007) Outpatient parenteral antimicrobial therapy (OPAT): is it safe for selected patients to self-administer at home? A retrospective analysis of a large cohort over 13 years. J Antimicrob Chemother 60: 356–362. doi: 10.1093/jac/dkm210 17566002
11. Kieran J, O’Reilly A, Parker J, Clarke S, Bergin C, (2009) Self-administered outpatient parenteral antimicrobial therapy: a report of three years experience in the Irish healthcare setting. Eur J Clin Microbiol Infect Dis 28: 1369–1374. doi: 10.1007/s10096-009-0794-5 19697069
12. Seaton RA, Barr DA, (2013) Outpatient parenteral antibiotic therapy: principles and practice. Eur J Intern Med 24: 617–623. doi: 10.1016/j.ejim.2013.03.014 23602223
13. Brown RB, (1991) Selection and training of patients for outpatient intravenous antibiotic therapy. Rev Infect Dis 13 (Suppl 2): S147–S151. 2017642
14. United States Census Bureau (2010) American FactFinder [database]. Available: http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml. Accessed 4 May 2015.
15. Shrestha NK, Bhaskaran A, Scalera NM, Schmitt SK, Rehm SJ, et al. (2012) Contribution of infectious disease consultation toward the care of inpatients being considered for community-based parenteral anti-infective therapy. J Hosp Med 7: 365–369. doi: 10.1002/jhm.1902 22315151
16. Huck D, Ginsberg JP, Gordon SM, Nowacki AS, Rehm SJ, et al. (2014) Association of laboratory test result availability and rehospitalizations in an outpatient parenteral antimicrobial therapy programme. J Antimicrob Chemother 69: 228–233. doi: 10.1093/jac/dkt303 23887864
17. Rosenbaum PR, Rubin DB, (1983) The central role of the propensity score in observational studies for causal effects. Biometrika 70: 41–55. doi: 10.1093/biomet/70.1.41
18. D’Agostino RB, JrD’Agostino RB, Sr (2007) Estimating treatment effects using observational data. JAMA 297: 314–316. 17227985
19. Austin PC, Mamdani MM, (2006) A comparison of propensity score methods: a case-control study estimating the effectiveness of post-AMI state. Stat Med 25: 2084–2106.
20. Torok ME, Chapman AL, Lessing MP, Sanderson F, Seaton RA, (2010) Outpatient parenteral antimicrobial therapy: recent developments and future prospects. Curr Opin Investig Drugs 11: 929–939. 20721835
21. Rubin DB, (2007) The design versus the analysis of observational studies for causal effects: parallels with the design of randomized trials. Stat Med 26: 20–36. doi: 10.1002/sim.2739 17072897
22. Austin PC, Mamdani MM, Stukel TA, Anderson GM, Tu JV, (2005) The use of the propensity score for estimating treatment effects: administrative versus clinical data. Stat Med 24: 1563–1578. 15706581
23. Kumar G, Taneja A, Majumdar T, Jacobs ER, Whittle J, et al. (2014) The association of lacking insurance with outcomes of severe sepsis: retrospective analysis of an administrative database. Crit Care Med 42: 583–591. 24152590
24. Gorey KM, Luginaah IN, Holowaty EJ, Zou G, Hamm C, et al. (2012) Effects of being uninsured or underinsured and living in extremely poor neighborhoods on colon cancer care and survival in California: historical cohort analysis, 1996–2011. BMC Pub Health 12: 897. doi: 10.1186/1471-2458-12-897
25. Aizer AA, Falit B, Mendu ML, Chen MH, Choueiri TK, et al. (2014) Cancer-specific outcomes among young adults without health insurance. J Clin Oncol 32: 2025–2030. doi: 10.1200/JCO.2013.54.2555 24888800
26. Greene WR, Oyetunji TA, Bowers U, Haider AH, Mellman TA, et al. (2010) Insurance status is a potent predictor of outcomes in both blunt and penetrating trauma. Am J Surg 199: 554–557. doi: 10.1016/j.amjsurg.2009.11.005 20359573
27. Bell TM, Zarzaur BL, (2013) Insurance status is a predictor of failure to rescue in trauma patients at both safety net and non-safety net hospitals. J Trauma Acute Care Surg 75: 728–733. 24064890
28. Bustamante AV, Fang H, Garza J, Carter-Pokras O, Wallace SP, et al. (2012) Variations in healthcare access and utilization among Mexican immigrants: the role of documentation status. J Immigr Minor Health 14: 146–155. doi: 10.1007/s10903-010-9406-9 20972853
29. Lerman-Garber I, Villa AR, Caballero E, (2004) Diabetes and cardiovascular disease. Is there a true Hispanic paradox? Rev Invest Clin 56: 282–296. 15612509
30. British Society for Antimicrobial Chemotherapy (2011) Outpatient and parenteral antimicrobial Therapy (OPAT): toolkit for developing a business case for OPAT services in the UK. Available: http://e-opat.com/wp-content/uploads/2014/11/Business_case_toolkit.pdf. Accessed 4 May 2015.
31. Rathert C, Wyrwich MD, Boren SA, (2013) Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev 70: 351–379. doi: 10.1177/1077558712465774 23169897
32. Leff B, Burton L, Mader SL, Naughton B, Burl J, et al. (2005) Hospital at home: feasibility and outcomes of a program to provide hospital-level care at home for acutely ill older patients. Ann Intern Med 143: 798–808. doi: 10.7326/0003-4819-143-11-200512060-00008 16330791