How Does Medical Policy on the Use of Prophylactic Antibiotics Affect Medical Costs, Length of Hospital Stay, and Antibiotic Use in Orthopedics?
How Does Medical Policy on the Use of Prophylactic Antibiotics Affect Medical Costs, Length of Hospital Stay, and Antibiotic Use in Orthopedics?
复制标题
DOI：
10.3349/ymj.2022.0546
复制
发表时间：
2023-03
影响因子：
2.4
通讯作者：
Kim GO
中科院分区：
文献类型：
--
作者：
Kim SH;Jang SY;Cha Y;Kim BY;Lee HJ;Kim GO
本研究的目的是比较接受脊柱手术（SS）和髋关节置换术（HAS）的患者，并分析来自“预防性抗生素适当使用的评价”的医疗政策如何影响韩国的住院时间（LOS）、直接医疗费用（DMC）和抗生素使用时间。这项回顾性全国性研究确定了2011年1月至2018年12月期间韩国国民健康保险审查和评估服务数据库中的受试者。2007年实施HAS（对照组）评价，2014年（干预时间）首次实施SS（病例组）评价。在我们的比较中断时间序列分析中，我们比较了两组之间的DMC，LOS和抗生素的使用。177468例接受SS的患者和89372例接受HAS的患者被纳入研究。2016年，HAS的DMC比SS增加了1.03倍（p=0.041）。然而，在其他观察期间，SS的成本变化并不高于HAS（p>0.05）。SS在前2年的LOS减少了3%（p<0.05）。此后，SS的LOS变化不小于HAS。抗菌药物总用量和广谱抗菌药物使用量连续5年下降。该医疗政策在减少抗生素使用和持续时间方面是有效的，特别是在政策实施后的前2年。
The purpose of this study was to compare patients who had undergone spine surgery (SS) and hip arthroplasty surgery (HAS) and to analyze how medical policies drawn from “The Evaluation of the Appropriate Use of Prophylactic Antibiotics” have affected length of hospital stay (LOS), direct medical costs (DMC), and the duration of antibiotics use in Korea. This retrospective nationwide study identified subjects from the Korean National Health Insurance Review and Assessment Service database from January, 2011 to December, 2018. Evaluation of HAS (control group) was implemented in 2007, and that for SS (case group) was conducted for the first time in 2014 (intervention time). In our comparative interrupted time series analysis, we compared DMC, LOS, and use of antibiotics between both groups. 177468 patients who underwent SS and 89372 patients who underwent HAS were included in the study. In 2016, DMC increased for HAS, compared to SS, by 1.03 times (p=0.041). However, cost changes during other observational periods for SS were not higher than those for HAS (p>0.05). SS incurred a reduced LOS of 3% in the first 2 years (p<0.05). Thereafter, LOS changes in SS were not smaller than those in HAS. A decrease in the usage of total antibiotics and broad spectrum antibiotics was observed for 5 years. This medical policy was effective in terms of reducing usage and duration of antibiotics use, especially in the first 2 years after the implementation of the policy.
登录
查看更多内容
DOI：
10.5435/00124635-200805000-00007
发表时间：
2008-05-01
影响因子：
3.2
作者：
Prokuski, Laura
通讯作者：
Prokuski, Laura
影响因子：
4.8
作者：
Barker, FG
通讯作者：
Barker, FG
影响因子：
2.9
作者：
Ikeda Kurakawa, Kayo;Okada, Akira;Yasunaga, Hideo
通讯作者：
Yasunaga, Hideo
影响因子：
5.2
作者：
Walker, Heather;Patton, Andrea;Bell, Samira
通讯作者：
Bell, Samira
影响因子：
2
作者：
Cheadle, William G
通讯作者：
Cheadle, William G