(Oct 13) A NEW home-care service will let patients with hard-to-treat infections get their antibiotic treatments at home, instead of them having to stay in hospital, or go there every day for three to four weeks.

The new service, by the National University Hospital (NUH), is aimed at patients who have trouble walking, particularly the elderly, and is expected to save each of them up to $160 a day.

This could add up to savings of $4,480 over four weeks.

Associate Professor Dale Fisher, a senior consultant from NUH's division of infectious diseases who started the service, said: 'My main motive is what's best for the patient. If it were me, I'd rather be in my own bed, with my family. It's much more convenient for the patient.'

These are patients who suffer from more stubborn infections, such as of the bone or urinary tract, which require prolonged treatment of antibiotics given intravenously over weeks or even months.

A nurse goes to the patient's home every day and administers the antibiotics, either by injection or drip. She may also fit the patient with a device which pumps the drugs into the vein over 24 hours.

Patients then have to go back to hospital just once a week for a review by the doctor.

The service costs about $50 to $100 a day for subsidised patients, and about $150 a day for private patients.

In 2004, NUH allowed patients who could walk or were not confined to a bed to visit the hospital daily for their injections, rather than admit them for the whole course of treatment.

Family members of some patients were also trained to refill the antibiotic pump for use at home. In this way, the patients would need to go to hospital only once a week.

This has freed some 40 hospital beds every month for others who needed them more, estimated Prof Fisher.

He cited the programme as an example of how treatment could be streamlined and waste reduced during the Lean Healthcare Conference on Wednesday.

Since 2004, 390 patients have benefited from the outpatient antibiotic service.

Ms Stella Teo, whose 77-year-old mother developed a bone infection after she fell and hurt her leg, was grateful for the home-care service.

Her mother spent a month in hospital, but wanted to be discharged in February this year in time for the Chinese New Year.

Over the next month, a nurse came by every day to give her an injection.

Ms Teo, 55, an accounts clerk, said: 'There's no way my maid and I could have got her in a taxi, and taken her to hospital every day. If it hadn't been for this service, we probably would have admitted her to hospital again after the holidays.'

Singapore General Hospital (SGH) and Tan Tock Seng Hospital (TTSH) also run outpatient antibiotic services, but do not offer home visits.

TTSH was the first to start such a programme in 2001.

SGH, which followed in June 2003, said most of its patients have no mobility problems, but it would consider providing home care if the demand for it increased.

huichieh@sph.com.sg