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August-September 2013
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IDSA/Avalere Study Demonstrates the Value of the ID Specialist

A study by researchers at IDSA and Avalere released online in Clinical Infectious Diseases provides documented evidence that early intervention by an infectious disease (ID) specialist saves lives and reduces medical costs. The study analyzed data on 130,000 hospitalized Medicare patients with one of 11 common infections and compared outcomes of those treated by an ID specialist to those who were not.

According to the data, hospitalized patients with severe infections treated by ID specialists are 9 percent less likely to die in the hospital and 12 percent less likely to die after discharge. Patients experience an average 3.7 percent fewer days in an intensive care unit and are less likely to be readmitted to the hospital within 30 days.

The study found that the benefits are even more pronounced when patients are seen by an ID specialist within two days of admission, minimizing hospital readmissions and lowering medical costs by 6 percent.

Researchers looked at a sample of Medicare patients who were hospitalized between Jan. 1, 2008 and Dec. 31, 2009 and had at least one of the following infections: bacteremia, Clostridium difficile, CLABSI, bacterial endocarditis, HIV/opportunistic infections, meningitis, osteomyelitis, prosthetic joint infections, septic arthritis, septic shock, and vascular device infections. Matching patient characteristics, researchers compared the outcomes of 61,680 cases in which a hospitalized patient saw an ID specialist to 65,192 cases that did not involve an ID specialist.

“These findings are in line with health care reform efforts being implemented through the Affordable Care Act, which shows that including ID specialists in up-front care of patients provides better outcomes at lower costs,” said study author Daniel McQuillen, MD, FIDSA. "Further, the association of ID specialist involvement with reduced readmission rates suggests an important role for the ID physician in transitions of care from the hospital to the community.”

IDSA is developing a toolbox of resources to help ID specialists explain the implications of the study to hospital administrators, health plan executives, and other decision-makers. Study lead author Steven K. Schmitt, MD, FIDSA, who chairs IDSA’s Clinical Affairs Committee, will talk about this toolbox in a symposium at IDWeek on “Payment Reform as the Driver for Healthcare Reform.” The toolbox is also available online at www.idsociety.org/Value_of_ID_Toolkit (member log in required).

“This study represents both the culmination of many years of hard work and marks the launch of a new ongoing campaign by the Society to demonstrate the value of the ID specialist. It also provides a basis for ensuring appropriate payment for ID services and for attracting new physicians into the field,” said David Relman, MD, FIDSA, president of IDSA. “Drs. Schmitt and McQuillen and their co-authors are to be commended.”

The study, “Infectious Diseases Specialty Intervention is Associated with Decreased Mortality and Lower Healthcare Costs,” is the first of its kind to evaluate the impact of a medical specialty on outcomes. It is available now online and will be published in the December 15 issue of Clinical Infectious Diseases.
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