PMID- 29543100
OWN - NLM
STAT- MEDLINE
DCOM- 20180928
LR  - 20181001
IS  - 1502-7708 (Electronic)
IS  - 0036-5521 (Linking)
VI  - 53
IP  - 4
DP  - 2018 Apr
TI  - Outpatient management of acute uncomplicated diverticulitis results in 
      health-care cost savings.
PG  - 449-452
LID - 10.1080/00365521.2018.1448887 [doi]
AB  - PURPOSE: Outpatient management without antibiotics has been shown to be safe for 
      selected patients diagnosed with acute uncomplicated diverticulitis (AUD). The 
      aim of this study was to evaluate the impact on admissions, complication rates 
      and health-care costs of the policy of outpatient treatment without using 
      antibiotics. METHODS: The medical records of all patients diagnosed with AUD in 
      the year before (2011) and after (2014) the implementation of outpatient 
      management without antibiotics in Vastmanland County were reviewed. Health-care 
      cost analysis was performed using the Swedish cost-per-patient model. RESULTS: In 
      total, 494 episodes of AUD were identified, 254 in 2011 and 240 in 2014. The 
      proportion of patients managed as outpatients was 20% in 2011 compared with 60% 
      in 2014 (p < .001). There were 203 hospital admissions and a total length of stay 
      of 677 days in 2011 compared with 95 admissions and 344 days in 2014 (both 
      p < .001). The total health-care cost was euro558,679 in 2011 compared with euro370,370 
      in 2014 (p < .001). Three patients developed complications in 2011 and four in 
      2014 (p = .469). CONCLUSIONS: The new policy of outpatient management without 
      antibiotics in routine health care almost halved the total health-care cost 
      without an increase in the complication rate.
FAU - Isacson, Daniel
AU  - Isacson D
AD  - a Colorectal Unit, Department of Surgery , Centre for Clinical Research Uppsala 
      University, Vastmanlands Hospital Vasteras , Vasteras , Sweden.
FAU - Andreasson, Karl
AU  - Andreasson K
AD  - a Colorectal Unit, Department of Surgery , Centre for Clinical Research Uppsala 
      University, Vastmanlands Hospital Vasteras , Vasteras , Sweden.
FAU - Nikberg, Maziar
AU  - Nikberg M
AD  - a Colorectal Unit, Department of Surgery , Centre for Clinical Research Uppsala 
      University, Vastmanlands Hospital Vasteras , Vasteras , Sweden.
FAU - Smedh, Kenneth
AU  - Smedh K
AD  - a Colorectal Unit, Department of Surgery , Centre for Clinical Research Uppsala 
      University, Vastmanlands Hospital Vasteras , Vasteras , Sweden.
FAU - Chabok, Abbas
AU  - Chabok A
AD  - a Colorectal Unit, Department of Surgery , Centre for Clinical Research Uppsala 
      University, Vastmanlands Hospital Vasteras , Vasteras , Sweden.
LA  - eng
PT  - Journal Article
DEP - 20180315
PL  - England
TA  - Scand J Gastroenterol
JT  - Scandinavian journal of gastroenterology
JID - 0060105
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Acute Disease
MH  - Ambulatory Care/*economics/methods
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Cost Savings
MH  - Diverticulitis/diagnostic imaging/*economics/therapy
MH  - Female
MH  - Health Care Costs/*statistics & numerical data
MH  - Hospitalization/*economics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Practice Guidelines as Topic
MH  - Retrospective Studies
MH  - Sweden
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Diverticulitis
OT  - antibiotics
OT  - health-care costs
OT  - outpatient management
EDAT- 2018/03/16 06:00
MHDA- 2018/10/03 06:00
CRDT- 2018/03/16 06:00
PHST- 2018/03/16 06:00 [pubmed]
PHST- 2018/10/03 06:00 [medline]
PHST- 2018/03/16 06:00 [entrez]
AID - 10.1080/00365521.2018.1448887 [doi]
PST - ppublish
SO  - Scand J Gastroenterol. 2018 Apr;53(4):449-452. doi: 
      10.1080/00365521.2018.1448887. Epub 2018 Mar 15.