Cost-effectiveness and budget impact of the management of uncomplicated urinary tract infection by community pharmacists
Bibliographic record
Abstract
BACKGROUND: OUTMAP study demonstrated that management of uncomplicated UTI by community pharmacists resulted in high clinical cure rates similar to those reported in the literature and a high degree of patient satisfaction. The objective of this study was to assess the cost-effectiveness and budget impact of community pharmacist-initiated compared to family or emergency physician-initiated management of uncomplicated UTI. METHODS: A decision analytic model was used to compare costs and outcomes of community pharmacist-initiated management of uncomplicated UTI to family or emergency physician-initiated management. Cure rates and utilities were derived from published studies. Costs of antibiotic treatment and health services use were calculated based on cost data from Canada. We used a probabilistic analysis to evaluate the impact of treatment strategies on costs and quality-adjusted-life-months (QALMs). In addition, a budget impact analysis was conducted to evaluate the financial impact of community pharmacist-initiated uncomplicated UTI management in this target population. This study was conducted from the perspective of the public health care system of Canada. RESULTS: Pharmacist-initiated management was lower cost ($72.47) when compared to family and emergency physician-initiated management, $141.53 and $368.16, respectively. The QALMs gained were comparable across the management strategies. If even only 25% of Canadians with uncomplicated UTI were managed by community pharmacists over the next 5 years, the resulting net total savings was estimated at $51 million. CONCLUSION: From a Canadian public health care system perspective, community pharmacist-initiated management would likely be a cost-effective strategy for uncomplicated UTI. In an era of limited health care resources, expanded roles of community pharmacists or other non-physician community based prescribers are important mechanisms through which accessible, high-quality and cost-effective care may be achieved. Further studies to evaluate other conditions which can be managed in the community and their cost effectiveness are essential.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".