This study systematically analyzed five outpatient parenteral antimicrobial therapy (OPAT) service models and their cost variations in a tertiary hospital in France, highlighting the diversity of coordination and monitoring practices and the impact of a lack of standardized team structures on service quality and cost-effectiveness. The findings provide important insights for optimizing outpatient antibiotic management.
Literature Overview
This article, 'Outpatient Parenteral Antimicrobial Therapy in a Tertiary Hospital in France: A Description of Service Models and Costs,' published in the journal Antibiotics, reviews and summarizes the diversity of OPAT service models and their associated costs in a French tertiary hospital. The study indicates that although OPAT offers significant advantages in reducing hospitalization time and costs, its implementation varies widely across departments, affecting treatment safety and effectiveness.
Background Knowledge
Outpatient Parenteral Antimicrobial Therapy (OPAT) is a strategy that transfers intravenous antibiotic treatment from the hospital to home or outpatient settings, commonly used for managing complex infections. In recent years, developments in this field have primarily focused on optimizing service structures to enhance patient safety and reduce adverse events (AEs) and readmission rates. Although international guidelines recommend multidisciplinary teams including infectious disease specialists, pharmacists, and specialized nurses, coordination mechanisms remain highly heterogeneous in actual practice. This study focuses on the real-world implementation of OPAT coordination and monitoring across different departments in a French tertiary hospital, aiming to identify variations in cost-effectiveness and opportunities for service optimization.
Research Methods and Experiments
The study employed a mixed-methods design using an explanatory sequential approach within a tertiary hospital in Paris, France. Qualitative data were collected through semi-structured interviews with 10 prescribing physicians and OPAT coordinators, and an inductive analytical approach was used to develop a framework of OPAT service models. The interviews covered core aspects including prescription, coordination, monitoring, and resource allocation, with researchers ensuring data saturation and cross-validation.
Key Conclusions and Perspectives
Research Significance and Prospects
This study reveals the heterogeneity of OPAT service models within a French tertiary hospital and addresses potential trade-offs between cost and quality. Future research should further analyze 30-day readmission rates, AE incidence, and treatment interruptions across models to identify optimal coordination mechanisms. Additionally, as Antimicrobial Stewardship (AMS) and antimicrobial management principles gain traction, establishing standardized OPAT teams and optimizing service models can improve treatment quality, reduce drug resistance risks, and alleviate hospitalization burdens.
Conclusion
This study identified five OPAT service models in a French tertiary hospital, with annual treatment volumes ranging from 3 to 450 cases. All models rely on external visiting nurses for treatment management, but exhibit significant differences in coordination mechanisms, monitoring frequency, and team composition. Cost analysis shows that the standardized cost for a 7-day treatment course ranges from €1445 to €2308, with Hospital-at-Home (HaH) services having the highest cost. The study indicates that the lack of a standardized multidisciplinary OPAT team may compromise treatment safety and resource coordination, thus affecting patient outcomes. Future efforts should focus on developing standardized OPAT service models that integrate specialized nurses and信息化 management systems to enhance the quality of antimicrobial management and reduce adverse events.
