The Economic Value of Rapid AST in Reducing Length of Stay of Septic Patients

We construct an economic model to estimate the potential length-of-stay cost savings for hospitals which replace conventional antibiotic susceptibility testing (AST) with rapid AST for the sepsis patient population. We used a wide range of academic studies from the medical and economics literature. Relevant studies were identified and weighted based on study methodological rigor, year of publication and geographic proximity of study population. Each flagged study was read in its entirety and screened for relevant data on inputs to the economic model. Studies which included relevant estimates were read again by two authors to confirm the correct estimate. Each component of the model was compiled from a comprehensive literature search identifying key studies in the field and then combining individual estimates from these studies into a weighted average. Implementation of rapid AST in the sepsis patient population can lead to over $1,600 of savings per sepsis case, or 7.3% of total average admission costs, solely in savings from improved length-of-stay (LOS). When scaled to the hospital level, this represents $5.65 million saved per 100,000 total hospital admissions. The magnitude of potential savings suggests that replacing conventional AST with rapid AST could provide a high return on investment for hospital systems.

Keywords: Rapid AST; Sepsis; Post-surgical infection; Blood cultures; Length of stay