Outpatient use of ceftriaxone: a cost-benefit analysis

Patients who participated in an outpatient intravenous therapy program designed to limit hospitalization for those who could be maintained on ceftriaxone at home were interviewed regarding costs and benefits. Of the 79 patients interviewed concerning 83 therapeutic episodes, 43.4 percent were able to perform their usual activities as soon as they began the program, 28.9 percent were restricted for part of the time, and 27.7 percent never resumed their usual activities. The 83 therapeutic episodes represent a total of 2,409 outpatient days (mean 29.7; standard deviation [SD] 17.7), 1,406 of which represent unrestricted activities. Costs and benefits of the program were calculated separately for four employment groups: not employed; usually employed, but not while on intravenous therapy; employed while on intravenous therapy, with time off for follow-up visits; and employed while on intravenous therapy, no time off for follow-up required. The mean total benefit, weighted across all four groups, was $6,588.14 (SD = $3,802.90) per patient. Mean weighted costs totalled $1,768.02 (SD = $1,129.36). The overall weighted benefit/cost ratio was approximately 5:1. Although private insurers reimbursed 63 percent of the patients for all hospitalization costs, only 39 percent were fully covered for the follow-up physician visits required during outpatient therapy.