{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T09:08:42Z","timestamp":1740128922164,"version":"3.37.3"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"an unrestricted"},{"DOI":"10.13039\/501100008002","name":"Vancouver Coastal Health Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In 2011, policymakers in British Columbia introduced a fee-for-service payment to incentivize infectious diseases physicians to supervise outpatient parenteral antimicrobial therapy (OPAT). Whether this policy increased use of OPAT remains uncertain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective cohort study using population-based administrative data over a 14-year period (2004\u20132018). We focused on infections that required intravenous antimicrobials for \u226510 days (eg, osteomyelitis, joint infection, endocarditis) and used the monthly proportion of index hospitalizations with a length of stay shorter than the guideline-recommended \u201cusual duration of intravenous antimicrobials\u201d (LOS &amp;lt; UDIVA) as a surrogate for population-level OPAT use. We used interrupted time series analysis to determine whether policy introduction increased the proportion of hospitalizations with LOS &amp;lt; UDIVA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 18 513 eligible hospitalizations. In the pre-policy period, 82.3% of hospitalizations exhibited LOS &amp;lt; UDIVA. Introduction of the incentive was not associated with a change in the proportion of hospitalizations with LOS &amp;lt; UDIVA, suggesting that the policy intervention did not increase OPAT use (step change, \u22120.06%; 95% confidence interval [CI], \u22122.69% to 2.58%; P = .97 and slope change, \u22120.001% per month; 95% CI, \u2212.056% to .055%; P = .98).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The introduction of a financial incentive for physicians did not appear to increase OPAT use. Policymakers should consider modifying the incentive design or addressing organizational barriers to expanded OPAT use.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad082","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T15:14:39Z","timestamp":1676560479000},"page":"2098-2105","source":"Crossref","is-referenced-by-count":2,"title":["Physician Financial Incentives for Use of Outpatient Intravenous Antimicrobial Therapy: An Interrupted Time Series Analysis"],"prefix":"10.1093","volume":"76","author":[{"given":"John A","family":"Staples","sequence":"first","affiliation":[{"name":"Department of Medicine, University of British Columbia , Vancouver , Canada"},{"name":"Centre for Clinical Epidemiology & Evaluation , Vancouver , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of British Columbia , Vancouver , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dwight","family":"Ferris","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of British Columbia , Vancouver , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guiping","family":"Liu","sequence":"additional","affiliation":[{"name":"Center for Health Services and Policy Research, School of Population and Public Health, University of British Columbia , Vancouver , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey R","family":"Brubacher","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of British Columbia , Vancouver , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayesha","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of British Columbia , Vancouver , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Daly-Grafstein","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of British Columbia , Vancouver , Canada"},{"name":"Department of Statistics, University of British Columbia , Vancouver , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen C","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of British Columbia , Vancouver , Canada"},{"name":"Centre for Health Evaluation & Outcome Sciences , Vancouver , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason M","family":"Sutherland","sequence":"additional","affiliation":[{"name":"Center for Health Services and Policy Research, School of Population and Public Health, University of British Columbia , Vancouver , Canada"},{"name":"Centre for Health Evaluation & Outcome Sciences , Vancouver , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"2023061611264913500_ciad082-B1","doi-asserted-by":"crossref","first-page":"f1585","DOI":"10.1136\/bmj.f1585","article-title":"Outpatient parenteral antimicrobial therapy","volume":"346","author":"Chapman","year":"2013","journal-title":"BMJ"},{"key":"2023061611264913500_ciad082-B2","first-page":"160","article-title":"Delivery models, efficacy, safety, and cost reduction of outpatient parenteral antimicrobial therapy in British Columbia","volume":"64","author":"Azhir","year":"2022","journal-title":"BCMJ"},{"key":"2023061611264913500_ciad082-B3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-013560","article-title":"Clinical and cost-effectiveness, safety and acceptability of community intravenous antibiotic service models: CIVAS systematic review","volume":"7","author":"Mitchell","year":"2017","journal-title":"BMJ Open"},{"key":"2023061611264913500_ciad082-B4","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciac298","article-title":"Outpatient versus inpatient intravenous antimicrobial therapy: a population-based observational cohort study of adverse events and costs","volume":"75","author":"Staples","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2023061611264913500_ciad082-B5","doi-asserted-by":"crossref","first-page":"451","DOI":"10.2165\/00019053-200018050-00004","article-title":"Cost analysis of an adult outpatient parenteral antibiotic therapy (OPAT) programme. 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