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Treating patients with opioid overdose at a primary care emergency outpatient clinic: a cost-minimization analysis
BACKGROUND: Treating patients with acute poisoning by substances of abuse in a primary care emergency clinic has previously been shown to be a safe strategy. We conducted an economic evaluation of this strategy compared to hospital treatment, which is the usual strategy. METHODS: Assuming equal heal...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8335998/ https://www.ncbi.nlm.nih.gov/pubmed/34348747 http://dx.doi.org/10.1186/s12962-021-00303-6 |
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author | Vibeto, Jon Hjellum Vallersnes, Odd Martin Dobloug, Andrea Brekke, Mette Jacobsen, Dag Ekeberg, Øivind Wangen, Knut Reidar |
author_facet | Vibeto, Jon Hjellum Vallersnes, Odd Martin Dobloug, Andrea Brekke, Mette Jacobsen, Dag Ekeberg, Øivind Wangen, Knut Reidar |
author_sort | Vibeto, Jon Hjellum |
collection | PubMed |
description | BACKGROUND: Treating patients with acute poisoning by substances of abuse in a primary care emergency clinic has previously been shown to be a safe strategy. We conducted an economic evaluation of this strategy compared to hospital treatment, which is the usual strategy. METHODS: Assuming equal health outcomes, we conducted a cost-minimization analysis. We constructed a representative opioid overdose patient based on a cohort of 359 patients treated for opioid overdose at the Oslo Accident and Emergency Outpatient Clinic (OAEOC) from 1.10.2011 to 30.9.2012. Using a health care system perspective, we estimated the expected resources used on the representative patient in primary care based on data from the observed OAEOC cohort and on information from key informants at the OAEOC. A likely course of treatment of the same patient in a hospital setting was established from information from key informants on provider procedures at Drammen Hospital, as were estimates of hospital use of resources. We calculated expected costs for both settings. Given that the treatments usually last for less than one day, we used undiscounted cost values. RESULTS: The estimated per patient cost in primary care was 121 EUR (2018 EUR 1.00 = NOK 9.5962), comprising 97 EUR on personnel costs and 24 EUR on treatment costs. In the hospital setting, the corresponding cost was 612 EUR, comprising 186 EUR on personnel costs, 183 EUR on treatment costs, and 243 EUR associated with intensive care unit admission. The point estimate of the cost difference per patient was 491 EUR, with a low-difference scenario estimated at 264 EUR and a high-difference scenario at 771 EUR. CONCLUSIONS: Compared to hospital treatment, treating patients with opioid overdose in a primary care setting costs substantially less. Our findings are probably generalizable to poisoning with other substances of abuse. Implementing elements of the OAEOC procedure in primary care emergency clinics and in hospital emergency departments could improve the use of health care resources. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12962-021-00303-6. |
format | Online Article Text |
id | pubmed-8335998 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-83359982021-08-04 Treating patients with opioid overdose at a primary care emergency outpatient clinic: a cost-minimization analysis Vibeto, Jon Hjellum Vallersnes, Odd Martin Dobloug, Andrea Brekke, Mette Jacobsen, Dag Ekeberg, Øivind Wangen, Knut Reidar Cost Eff Resour Alloc Research BACKGROUND: Treating patients with acute poisoning by substances of abuse in a primary care emergency clinic has previously been shown to be a safe strategy. We conducted an economic evaluation of this strategy compared to hospital treatment, which is the usual strategy. METHODS: Assuming equal health outcomes, we conducted a cost-minimization analysis. We constructed a representative opioid overdose patient based on a cohort of 359 patients treated for opioid overdose at the Oslo Accident and Emergency Outpatient Clinic (OAEOC) from 1.10.2011 to 30.9.2012. Using a health care system perspective, we estimated the expected resources used on the representative patient in primary care based on data from the observed OAEOC cohort and on information from key informants at the OAEOC. A likely course of treatment of the same patient in a hospital setting was established from information from key informants on provider procedures at Drammen Hospital, as were estimates of hospital use of resources. We calculated expected costs for both settings. Given that the treatments usually last for less than one day, we used undiscounted cost values. RESULTS: The estimated per patient cost in primary care was 121 EUR (2018 EUR 1.00 = NOK 9.5962), comprising 97 EUR on personnel costs and 24 EUR on treatment costs. In the hospital setting, the corresponding cost was 612 EUR, comprising 186 EUR on personnel costs, 183 EUR on treatment costs, and 243 EUR associated with intensive care unit admission. The point estimate of the cost difference per patient was 491 EUR, with a low-difference scenario estimated at 264 EUR and a high-difference scenario at 771 EUR. CONCLUSIONS: Compared to hospital treatment, treating patients with opioid overdose in a primary care setting costs substantially less. Our findings are probably generalizable to poisoning with other substances of abuse. Implementing elements of the OAEOC procedure in primary care emergency clinics and in hospital emergency departments could improve the use of health care resources. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12962-021-00303-6. BioMed Central 2021-08-04 /pmc/articles/PMC8335998/ /pubmed/34348747 http://dx.doi.org/10.1186/s12962-021-00303-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Vibeto, Jon Hjellum Vallersnes, Odd Martin Dobloug, Andrea Brekke, Mette Jacobsen, Dag Ekeberg, Øivind Wangen, Knut Reidar Treating patients with opioid overdose at a primary care emergency outpatient clinic: a cost-minimization analysis |
title | Treating patients with opioid overdose at a primary care emergency outpatient clinic: a cost-minimization analysis |
title_full | Treating patients with opioid overdose at a primary care emergency outpatient clinic: a cost-minimization analysis |
title_fullStr | Treating patients with opioid overdose at a primary care emergency outpatient clinic: a cost-minimization analysis |
title_full_unstemmed | Treating patients with opioid overdose at a primary care emergency outpatient clinic: a cost-minimization analysis |
title_short | Treating patients with opioid overdose at a primary care emergency outpatient clinic: a cost-minimization analysis |
title_sort | treating patients with opioid overdose at a primary care emergency outpatient clinic: a cost-minimization analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8335998/ https://www.ncbi.nlm.nih.gov/pubmed/34348747 http://dx.doi.org/10.1186/s12962-021-00303-6 |
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