Hospital Cost Savings in Testicular Cancer Patient with Sepsis
44 year old male with testicular cancer, recurrent diverticulitis admitted with sepsis, sigmoid colitis, and renal abscess. Started on empiric Zosyn and vancomycin by hospitalist.
ID telemedicine consultation obtained, reviewed all radiologic and culture data, and de-escalated and consolidated antibiotics to oral levofloxacin alone for an additional 12 days. Patient was spared 12 days of IV Zosyn and vancomycin, and placement of a PICC as well as 3 days of hospitalization.
Estimated cost of avoided hospitalization
(estimated 3-day length of stay)
Hospitalization
$7,800
Zosyn dosed 4 times per day x 12 days
$5,040
Vancomycin dosed 2 times per day x 12 days
$1,320
Peripherally inserted central venous catheter for IV antibiotics (PICC)
$1,800
Total Savings
$15,960
Saved $15,960
Saved $15,960. Patient and Hospital Cost Savings of Infectious Disease Telemedicine Consult with nodMD
This case also features several more difficult to quantify opportunity cost savings:
1) The risk of acute kidney failure with the combination of Zosyn and vancomycin is approximately 21% vs 8% for either drug alone
2) AKI can be severe enough to require hemodialysis, which can range from $240 per day up to $1,000 per day and sometimes is needed for 2 weeks or more
3) Lengths of stay are significantly prolonged in patients who develop AKI, with national averages of at least 5 additional days ($13,000)