Early onset sepsis calculator implementation is associated with reduced healthcare utilization and financial costs in late preterm and term newborns

Niek B Achten, Douwe H Visser, Ellen Tromp, Wim Groot, Johannes B van Goudoever, Frans B Plötz, Niek B Achten, Douwe H Visser, Ellen Tromp, Wim Groot, Johannes B van Goudoever, Frans B Plötz

Abstract

The neonatal early onset sepsis (EOS) calculator is a novel tool for antibiotic stewardship in newborns, associated with a reduction of empiric antibiotic treatment for suspected EOS. We studied if implementation of the EOS calculator results in less healthcare utilization and lower financial costs of suspected EOS. For this, we compared two single-year cohorts of hospitalizations within 3 days after birth in a Dutch nonacademic teaching hospital, before and after implementation of the EOS calculator. All admitted newborns born at or after 35 weeks of gestation were eligible for inclusion. We analyzed data from 881 newborns pre-implementation and 827 newborns post-implementation. We found significant reductions in EOS-related laboratory tests performed and antibiotic days, associated with implementation of the EOS calculator. Mean length of hospital stay was shorter, and EOS-related financial costs were lower after implementation among term, but not among preterm newborns.Conclusion: In addition to the well-known positive impact on antibiotic stewardship, implementation of the EOS calculator is also clearly associated with reductions in healthcare utilization related to suspected EOS in late preterm and term newborns and with a reduction in associated financial costs among those born term.What is Known:• The early-onset sepsis (EOS) calculator is a novel tool for antibiotic stewardship in newborns, associated with a reduction in empiric antibiotic treatment for suspected EOS.What is New:• In newborns at risk for EOS, EOS calculator implementation is associated with a significant reduction in laboratory investigations related to suspected EOS and significantly shorter stay in those born term.• EOS calculator implementation in term newborns is associated with a mean reduction of €207 in costs for EOS-related care per admitted newborn.

Keywords: Costs; EOS calculator; Early-onset sepsis; Healthcare utilization; Newborn.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Study inclusion. Flowchart of study inclusion process
Fig. 2
Fig. 2
EOS-related healthcare utilization and associated costs before and after implementation of the EOS calculator. Distributions of the frequencies of clinical outcomes (panels A, B, and C) and associated costs (panels D through G), for cohorts before and after implementation. Frequency of zero as a value displayed as the first bin in continuous variables (panels A, B, and D through G). Outliers omitted from panels (A, n = 23; B, n = 9; C, n = 3; D, n = 20; E, n = 25, F, n = 1; G, n = 24) for optical clarity; no outliers were removed from analysis

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Source: PubMed

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