Benchmarks for antibiotic use and cost in long-term care
Benchmarks for antibiotic use and cost in long-term care
复制标题
DOI：
10.1111/j.1532-5415.2005.53351.x
复制
发表时间：
2005-07-01
影响因子：
6.3
通讯作者：
Keagle, J
中科院分区：
文献类型：
--
作者：
Mylotte, JM;Keagle, J
目的：评估先前描述的社区养老院抗生素使用和成本指标，以确定它们是否可能作为有用的基准，并评估功能状态、感染发生和抗生素使用之间的关系。设计：回顾性观察性研究。周边环境：一家公司拥有11家专有的长期护理机构。参与者：仅使用特定设施的累积数据。测量：抗生素使用和成本指标（抗生素使用发生率、抗生素使用率、每个住院护理日的抗生素成本（RCD）和每个抗生素日的成本）、感染率和功能状态，使用资源利用组11系统的病例组合指数（CMI）进行测量。为每个设施计算每项测量的年平均值。结果：11家养老院间抗菌药物指标均存在显著差异，但平均设施CMI与感染率无相关性。然而，平均设施CMI与平均设施抗生素使用发生率、抗生素使用率和每RCD成本之间存在显著相关的趋势。平均设施感染率的变化解释了66%的平均设施抗生素使用发生率的变化(P
OBJECTIVES: To evaluate previously described antibiotic use and cost indicators in community nursing homes to determine whether they may be useful as benchmarks and to evaluate the association between functional status, infection occurrence, and antibiotic use.DESIGN: Retrospective observational study.SETTING: Eleven proprietary long-term care facilities owned by one company.PARTICIPANTS: Only facility-specific cumulative data were used.MEASUREMENTS: Antibiotic use and cost indicators (incidence of antibiotic use, antibiotic utilization ratio, cost of antibiotics per resident care day (RCD), and cost per antibiotic day), infection rates, and functional status as measured using the case-mix index (CMI) of the Resource Utilization Groups 11 system. Mean yearly values for each measure were calculated for each facility.RESULTS: There was significant variation in all of the antibiotic indicators between the 11 nursing homes, but there was no correlation between mean facility CMI and infection rate. However, there was a trend toward a significant correlation between mean facility CMI and mean facility incidence of antibiotic use, antibiotic utilization rate, and cost per RCD. Variation in mean facility infection rate explained 66% of the variation in mean facility incidence of antibiotic use (P