Dataset Information

Validating hospital antibiotic purchasing data as a metric of inpatient antibiotic use.

ABSTRACT:

Objectives

Antibiotic purchasing data are a widely used, but unsubstantiated, measure of antibiotic consumption. To validate this source, we compared purchasing data from hospitals and external medical databases with patient-level dispensing data.

Methods

Antibiotic purchasing and dispensing data from internal hospital records and purchasing data from IMS Health were obtained for two hospitals between May 2013 and April 2015. Internal purchasing data were validated against dispensing data, and IMS data were compared with both internal metrics. Scatterplots of individual antimicrobial data points were generated; Pearson's correlation and linear regression coefficients were computed. A secondary analysis re-examined these correlations over shorter calendar periods.

Results

Internal purchasing data were strongly correlated with dispensing data, with correlation coefficients of 0.90 (95% CI = 0.83-0.95) and 0.98 (95% CI = 0.95-0.99) at hospitals A and B, respectively. Although dispensing data were consistently lower than purchasing data, this was attributed to a single antibiotic at both hospitals. IMS data were favourably correlated with, but underestimated, internal purchasing and dispensing data. This difference was accounted for by eight antibiotics for which direct sales from some manufacturers were not included in the IMS database. The correlation between purchasing and dispensing data was consistent across periods as short as 3 months, but not at monthly intervals.

Conclusions

Both internal and external antibiotic purchasing data are strongly correlated with dispensing data. If outliers are accounted for appropriately, internal purchasing data could be used for cost-effective evaluation of antimicrobial stewardship programmes, and external data sets could be used for surveillance and research across geographical regions.

SUBMITTER: Tan C

PROVIDER: S-EPMC4710217 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature

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Publications

Validating hospital antibiotic purchasing data as a metric of inpatient antibiotic use.

Tan Charlie C Ritchie Michael M Alldred Jason J Daneman Nick N

The Journal of antimicrobial chemotherapy 20151105 2

<h4>Objectives</h4>Antibiotic purchasing data are a widely used, but unsubstantiated, measure of antibiotic consumption. To validate this source, we compared purchasing data from hospitals and external medical databases with patient-level dispensing data.<h4>Methods</h4>Antibiotic purchasing and dispensing data from internal hospital records and purchasing data from IMS Health were obtained for two hospitals between May 2013 and April 2015. Internal purchasing data were validated against dispens ...[more]

PMID: 26546668

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Project description:BACKGROUND:Starting in fiscal year 2013, the Hospital Value-Based Purchasing (HVBP) program introduced quality performance-based adjustments of up to 1% to Medicare reimbursements for acute care hospitals. METHODS:We evaluated whether quality improved more in acute care hospitals that were exposed to HVBP than in control hospitals (Critical Access Hospitals, which were not exposed to HVBP). The measures of quality were composite measures of clinical process and patient experience (measured in units of standard deviations, with a value of 1 indicating performance that was 1 standard deviation [SD] above the hospital mean) and 30-day risk-standardized mortality among patients who were admitted to the hospital for acute myocardial infarction, heart failure, or pneumonia. The changes in quality measures after the introduction of HVBP were assessed for matched samples of acute care hospitals (the number of hospitals included in the analyses ranged from 1364 for mortality among patients admitted for acute myocardial infarction to 2615 for mortality among patients admitted for pneumonia) and control hospitals (number of hospitals ranged from 31 to 617). Matching was based on preintervention performance with regard to the quality measures. We evaluated performance over the first 4 years of HVBP. RESULTS:Improvements in clinical-process and patient-experience measures were not significantly greater among hospitals exposed to HVBP than among control hospitals, with difference-in-differences estimates of 0.079 SD (95% confidence interval [CI], -0.140 to 0.299) for clinical process and -0.092 SD (95% CI, -0.307 to 0.122) for patient experience. HVBP was not associated with significant reductions in mortality among patients who were admitted for acute myocardial infarction (difference-in-differences estimate, -0.282 percentage points [95% CI, -1.715 to 1.152]) or heart failure (-0.212 percentage points [95% CI, -0.532 to 0.108]), but it was associated with a significant reduction in mortality among patients who were admitted for pneumonia (-0.431 percentage points [95% CI, -0.714 to -0.148]). CONCLUSIONS:In our study, HVBP was not associated with improvements in measures of clinical process or patient experience and was not associated with significant reductions in two of three mortality measures. (Funded by the National Institute on Aging.).

Project description:The United States regulates the use of antibiotics in agricultural settings to address the global antibiotic resistance problem. Conventional dairy cows treated with antibiotics are kept in the herd and after the withholding period milk is harvested. On organic farms, the US organic standard on antibiotic use requires sick dairy cows to be treated, but treated cows must be removed from the herd and their milk can never again be sold as certified organic. This study investigated the US public's perceptions of the organic dairy farming, antibiotic use on dairy farms, and whether these perceptions affect consumer's self-reported purchasing behavior for organic. We used a nationally representative phone-based survey of 1000 US adults and characterized participants' self-reported (i) knowledge of the legality of antibiotic use on dairy farms (conventional and organic) and (ii) frequency of purchasing organic instead of conventional dairy products, as well as several demographic and other variables. The results indicated that participants' knowledge about antibiotic use practices in dairy farming have no effect on their self-reported purchasing behavior for organic or conventional dairy products. However, respondents who were familiar with the regulations of antibiotic use on dairy farms were more likely to oppose the US organic standard on antibiotic use in dairy farming and thought that past antibiotic use should not permanently remove a cow's organic status. These findings contribute to understanding of public perceptions that shape the US dairy organic market. PRACTICAL APPLICATION: Income, employment, health and political values, but not consumers' knowledge about antibiotic use in dairy farming, affect self-reported purchasing behavior for organic dairy products. However, consumers who are familiar with the regulations of antibiotic use on US dairy farms disagree with the US organic standard on antibiotic use mandating loss of organic status for any cattle treated with antibiotics. These findings may be useful to organic markets.

Dataset Information

Validating hospital antibiotic purchasing data as a metric of inpatient antibiotic use.

Objectives

Methods

Results

Conclusions

Publications

Validating hospital antibiotic purchasing data as a metric of inpatient antibiotic use.

Similar Datasets

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