Table 2.
Outcome Measures by Phase
| Outcome | Baseline | Phase 1 | Phase 2 | Phase 3 |
|---|---|---|---|---|
| Primary outcomes | ||||
| Length of intravenous antibiotic therapy, d | 3.49, 3.19–3.82 | 3.16, 2.68–3.74, P = .32 | 2.73, 2.36–3.16, P < .01 | 2.81, 2.41–3.28, P = .02 |
| Total length of antibiotic therapy, d | 6.4, 5.97–6.86 | 6.04, 5.33–6.86, P = .45 | 5.54, 4.96–6.19, P = .03 | 5.98, 5.31–6.73, P = .34 |
| Clinic outcomes | ||||
| Length of stay, d | 4.94, 4.53–5.39 | 4.54, 3.87–5.33, P = .37 | 4.46, 3.87–5.13, P = .21 | 4.68, 4.03–5.43, P = .54 |
| Inpatient mortality, % | 6.28, 4.26–9.17 | 6.51, 3.31–12.41, P = .93 | 4.31, 2.2–8.27, P = .31 | 4.28, 2.07–8.65, P = .35 |
| 30-d readmission, % | 12.81, 9.85–16.5 | 10.03, 5.98–16.34, P = .39 | 13.73, 9.03–20.33, P = .78 | 12.39, 7.91–18.9, P = .90 |
| Process outcomes | ||||
| Length of inpatient intravenous azithromycin therapy, d | 1.2, 1.09–1.33 | 1.09, 0.91–1.31, P = .35 | 1, 0.86–1.18, P = .05 | 0.99, 0.84–1.17, P = .05 |
| Length of inpatient azithromycin therapy, d | 1.91, 1.77–2.06 | 1.71, 1.48–1.96, P = .18 | 1.56, 1.37–1.76, P < .01 | 1.48, 1.3–1.69, P < .01 |
| Length of inpatient atypical antibiotic therapy, d | 2.35, 2.18–2.53 | 1.97, 1.72–2.26, P = .03 | 1.89, 1.68–2.13, P < .01 | 1.73, 1.52–1.96, P < .01 |
| Procalcitonin lab utilization, % | 47.91, 42.99–52.88 | 52.76, 43.67–61.68, P = .37 | 75.72, 68.73–81.57, P < .01 | 64.96, 56.58–72.51, P < .01 |
| Legionella and Streptococcus pneumoniae urine antigen utilization, % | 72.06, 67.41–76.28 | 76.41, 68.36–82.93, P = .33 | 78.58, 71.28–84.44, P = .13 | 78.2, 70.97–84.03, P = .14 |
| Cost outcomes | ||||
| Total cost per visit | 1, 0.9–1.12 | 0.79, 0.65–0.97, P = .05 | 0.8, 0.67–0.95, P = .03 | 0.84, 0.69–1.01, P = .11 |
| Facility utilization cost | 0.52, 0.47–0.58 | 0.43, 0.36–0.53, P = .11 | 0.44, 0.37–0.52, P = .11 | 0.47, 0.4–0.57, P = .41 |
| Pharmacy cost | 0.15, 0.13–0.18 | 0.1, 0.07–0.14, P = .05 | 0.1, 0.08–0.14, P = .03 | 0.12, 0.08–0.16, P = .16 |
| Laboratory cost | 0.1, 0.09–0.12 | 0.06, 0.05–0.08, P < .01 | 0.05, 0.04–0.07, P < .01 | 0.05, 0.04–0.06, P < .01 |
Values are expressed as estimated marginal mean, 95% confidence interval, P value based on gamma and logistic regression models adjusted for age, Charlson comorbidity index, CURB-65, and flu season. P values are based on the following comparisons: Baseline/Phase 1, Baseline/Phase 2 and Baseline/Phase 3. Cost data are normalized based on baseline total cost per visit.
Abbreviation: CURB 65 = confusion, urea >7mmol/L, respiratory rate ≥30/min, systolic blood pressure <90 mmHg, and age ≥65 score.