PMID- 37399927
OWN - NLM
STAT- MEDLINE
DCOM- 20231102
LR  - 20240418
IS  - 1544-3450 (Electronic)
IS  - 1086-5802 (Linking)
VI  - 63
IP  - 5
DP  - 2023 Sep-Oct
TI  - Home versus outpatient hospital intravenous immunoglobulin infusion and health 
      care resource utilization.
PG  - 1566-1573.e1
LID - S1544-3191(23)00234-0 [pii]
LID - 10.1016/j.japh.2023.06.021 [doi]
AB  - BACKGROUND: Home health care delivery is projected to increase. Intravenous 
      immunoglobulin (IVIG) therapy has high potential to move from the outpatient 
      hospital (OPH) setting to home delivery. OBJECTIVE: This study examined the 
      relationship between home and OPH IVIG infusions and health care utilization. 
      METHODS: We used a retrospective cohort study design and the Humana Research 
      Database to identify patients with 1 or more medical or pharmacy claims for an 
      IVIG infusion agent from January 1, 2017, to December 31, 2018. Eligible patients 
      were enrolled in a Medicare Advantage Prescription Drug (MAPD) or commercial 
      health plan, with at least 12 months of continuous enrollment before and after 
      their first infusion (i.e., index date) received in the home or OPH setting. We 
      measured the odds of experiencing an inpatient (IP) stay or emergency department 
      (ED) visit, adjusted for baseline differences in age, sex, race, region, 
      population density, low-income, and dual eligibility status, MAPD or commercial 
      health plan, plan type, treatment-naive status, home health use, RxRisk-V 
      comorbidity burden score, and indications for IVIG use. RESULTS: A total of 208 
      and 1079 patients received IVIG infusions in the home and OPH setting, 
      respectively. The odds for an IP stay (odds ratio [OR] 0.56 [95% CI 0.38-0.82]) 
      and ED visit (OR 0.62 [95% CI 0.41-0.93]) were significantly lower in patients 
      who received IVIG infusion in the home than patients receiving infusion in the 
      OPH setting. CONCLUSIONS: Our findings suggest there may be value to increasing 
      referrals for IVIG home infusion. Decreased health care utilization provides 
      value to the system in cost savings and to patients and families owing to less 
      disruption and improved clinical outcomes. Further study can help inform health 
      policy designed to maximize the benefits of IVIG home infusion while minimizing 
      potential risks.
CI  - Copyright (c) 2023 American Pharmacists Association(R). Published by Elsevier Inc. 
      All rights reserved.
FAU - Rastegar, Jeremiah
AU  - Rastegar J
FAU - Brown, Victoria T
AU  - Brown VT
FAU - John, Isha
AU  - John I
FAU - Dixon, Suzanne W
AU  - Dixon SW
FAU - Rodman, Elizabeth
AU  - Rodman E
FAU - Ellis, Jeffrey J
AU  - Ellis JJ
FAU - Poonawalla, Insiya B
AU  - Poonawalla IB
LA  - eng
PT  - Journal Article
DEP - 20230701
PL  - United States
TA  - J Am Pharm Assoc (2003)
JT  - Journal of the American Pharmacists Association : JAPhA
JID - 101176252
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Aged
MH  - Humans
MH  - United States
MH  - *Immunoglobulins, Intravenous/therapeutic use
MH  - Retrospective Studies
MH  - *Outpatients
MH  - Medicare
MH  - Delivery of Health Care
MH  - Patient Acceptance of Health Care
MH  - Hospitals
EDAT- 2023/07/04 01:05
MHDA- 2023/07/04 01:06
CRDT- 2023/07/03 19:20
PHST- 2023/02/09 00:00 [received]
PHST- 2023/06/13 00:00 [revised]
PHST- 2023/06/26 00:00 [accepted]
PHST- 2023/07/04 01:06 [medline]
PHST- 2023/07/04 01:05 [pubmed]
PHST- 2023/07/03 19:20 [entrez]
AID - S1544-3191(23)00234-0 [pii]
AID - 10.1016/j.japh.2023.06.021 [doi]
PST - ppublish
SO  - J Am Pharm Assoc (2003). 2023 Sep-Oct;63(5):1566-1573.e1. doi: 
      10.1016/j.japh.2023.06.021. Epub 2023 Jul 1.