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Titolo:
Antimicrobial expenditures and usage at four university hospitals
Autore:
Kern, WV; Rose, AD; Hay, B; Muche, R; Frank, U;
Indirizzi:
Ulm Univ Hosp & Med Ctr, Sect Infect Dis & Clin Immunol, D-89070 Ulm, Germany Ulm Univ Hosp & Med Ctr Ulm Germany D-89070 mmunol, D-89070 Ulm, Germany Univ Ulm, Dept Biometry & Clin Documentat, D-89069 Ulm, Germany Univ Ulm Ulm Germany D-89069 try & Clin Documentat, D-89069 Ulm, Germany Univ Hosp, Dept Environm Med & Hosp Epidemiol, D-79106 Freiburg, Germany Univ Hosp Freiburg Germany D-79106 Epidemiol, D-79106 Freiburg, Germany
Titolo Testata:
INFECTION
fascicolo: 3, volume: 29, anno: 2001,
pagine: 127 - 137
SICI:
0300-8126(200105/06)29:3<127:AEAUAF>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANTIBIOTIC USE; GUIDELINES; PATTERNS; OUTCOMES; QUALITY; PROGRAM; IMPACT; AGENTS; MANAGEMENT; PREVALENCE;
Keywords:
antibiotic use; antibiotic cost; hospital expenditures; health economics; pharmacoepidemiology; infectious disease service; quality management;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
47
Recensione:
Indirizzi per estratti:
Indirizzo: Kern, WV Ulm Univ Hosp & Med Ctr, Sect Infect Dis & Clin Immunol, D-89070 Ulm, Germany Ulm Univ Hosp & Med Ctr Ulm Germany D-89070 -89070 Ulm, Germany
Citazione:
W.V. Kern et al., "Antimicrobial expenditures and usage at four university hospitals", INFECTION, 29(3), 2001, pp. 127-137

Abstract

Background: The increasing use of antimicrobial drugs is resulting in enormous hospital expenditures. Careful assessment of inappropriate prescribingand a search for more cost-effective treatment strategies are urgently required. Comparisons between hospitals should help identify areas of inappropriate prescribing as well as effective drug use programs, but such analysesmay be severely biased if the impact of different case-mixes is not recognized. Patients and Methods: We studied antimicrobial usage and expenditures at four state university hospitals in southwestern Germany and assessed the significance of differences between hospital services after adjustment for patient variables. A prevalence survey was done with review of 2,254 charts ofpatients admitted to the surgical, medical and pediatric services to obtain information on antimicrobial drug prescription and expenditures in the week preceding the survey. Results: According to pharmacy data for the year 1994, maximal differencesbetween these hospitals in the antibiotic costs per patient-day were 1.9-fold (surgical services), 1.5-fold (medical services), and 1.6-fold (pediatric services). In a multivariate analysis, adjusted antibiotic prescription prevalence rates did not differ for medical and pediatric service patients,but did differ for surgical service patients (p = 0.03), Similarly, adjusted expenditures per patient-week differed significantly between hospitals far surgical service patients (p = 0.001), but only marginally for medical(p= 0.14) and pediatric (p = 0.05) service patients. The adjusted differencein expenditures between surgical departments was as Large as 2.8-fold (95%CI 1.8 to 4.3) and was primarily related to preferential use of expensive iv antimicrobial drugs. Conclusion: In two hospitals, Lowest expenditures in either surgery or medicine were associated with active antimicrobial drug use programs suggesting an impact of these programs on drug use and expenditures Limited to theseservices. The identification of such Large patient-mix unrelated differences in antimicrobial usage and expenditures offers opportunities for qualityimprovements and cost reduction.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/20 alle ore 04:50:56