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OPAT fee-for-service payment

"The introduction of a financial incentive for physicians did not appear to increase OPAT use. Policymakers should consider modifying the incentive design or addressing organizational barriers to expanded OPAT use" Staples et al (2023).

"The introduction of a financial incentive for physicians did not appear to increase OPAT use. Policymakers should consider modifying the incentive design or addressing organizational barriers to expanded OPAT use" Staples et al (2023).

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OPAT fee-for-service payment

Abstract:

Background: In 2011, policymakers in British Columbia introduced a fee-for-service payment incentivizing Infectious Diseases physicians to supervise outpatient parenteral antimicrobial therapy (OPAT). Whether this policy increased use of OPAT remains uncertain.

Methods: We conducted a retrospective cohort study using population-based administrative data over a 14-year period (2004-2018). We focused on infections requiring intravenous antimicrobials for ≥10 days (e.g., osteomyelitis, joint infection, endocarditis) and used the monthly proportion of index hospitalizations with length of stay shorter than the guideline-recommended ‘usual duration of intravenous antimicrobials’ (LOS

Results: We identified 18,513 eligible hospitalizations. In the pre-policy period, 82.3% of hospitalizations exhibited LOS

Conclusion: The introduction of a financial incentive for physicians did not appear to increase OPAT use. Policymakers should consider modifying the incentive design or addressing organizational barriers to expanded OPAT use.


Reference:

Staples JA, Ho M, Ferris D, Liu G, Brubacher JR, Khan M, Daly-Grafstein D, Tran KC, Sutherland JM. Physician financial incentives for use of outpatient intravenous antimicrobial therapy (OPAT): an interrupted time series analysis. Clin Infect Dis. 2023 Feb 16:ciad082. doi: 10.1093/cid/ciad082. Epub ahead of print. PMID: 36795054.

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