Posted on March 9, 2015
Antimicrobial stewardship programs (ASPs) stand out as initiatives that both improve patient care and protect hospitals’ bottom lines. In fact, hospitals that implement ASPs save $200,000 to $900,000 in direct costs.1
They reduce healthcare-associated infections (HAIs). Infections cost US hospitals $20 million to $35 million annually in medications, labor and care costs. HAIs account for about 70% of these infections—and the costs for them are non-reimbursable by Medicare and many private insurers. An antimicrobial stewardship program that uses automated surveillance systems can quickly identify infections so they can be promptly treated and kept from spreading. An HAI on average extends a patient’s stay by 9.58 days and leads to $38,656 in excess charges; each one avoided (or quickly treated) saves a hospital significant money.
Antimicrobial stewardship programs help hospitals avoid penalties and fines. In 2014, 721 hospitals had their Medicare reimbursements reduced 1% as a penalty for high HAI rates. In addition, 2,610 hospitals were fined for excessive numbers of readmissions, frequently a consequence of HAIs. With up to 5% of Medicare reimbursements now at risk, hospitals that implement ASPs and reduce HAIs will find themselves in safer financial territory.
They reduce the inappropriate use of antimicrobials. Hospitals that implement high-performing ASPs reduce antimicrobial use by 15% to 25%. About 50% of antibiotic prescriptions in the average U.S. hospital are unnecessary or inappropriate, providing substantial room for improved prescribing practices and cost reduction.2
They reduce drug costs. Antimicrobial stewardship programs help ensure patients receive the correct drug at the correct dosage for the correct duration, so patients don’t receive more medication than needed to effectively treat the infection. In addition, many ASPs incorporate other steps that reduce costs, including intravenous to oral conversion for stable patients, formulary restrictions or preauthorization for expensive, broad-spectrum antimicrobials, and prescriber education and feedback on the most effective therapies for specific infections. Hospitals that implement these steps can cut their antimicrobial pharmacy costs by up to 35%.
Antimicrobial stewardship programs reduce the number of treatment failures and patients’ lengths of stay. Electronic components to ASPs that generate an antibiogram for facilities or units improve empiric therapy, and surveillance components that alert pharmacists to bug-drug mismatches and untreated infections can reduce treatment failures, improve patient care and reduce the cost of inappropriately or untreated infections. Patients who require less medication, improve faster and go home earlier, leading to lower costs.
IDSA/SHEA Guidelines for Antimicrobial Stewardship Programs http://www.journals.uchicago.edu/doi/pdf/10.1086/510393
CDC. Get Smart for Healthcare: Know When Antibiotics Work. National Center for Emerging and Zoonotic Infectious Disease. Division of Healthcare Quality Promotion