Cost-effectiveness of prospective and continuous parenteral antibiotic control: Experience at the Palo Alto Veterans affairs medical center from 1987 to 1989

摘要: Abstract purpose: Controlling inappropriate antibiotic usage is a major focus for hospital quality assurance and cost-containment programs. We assessed the impact of strengthening parenteral control policy instituting continuous infectious disease service (IDS) reviews appropriateness antimicrobial therapy on cost patient outcomes. patients methods: All receiving intravenous antibiotics during 3.5-year period from 1986 to 1989 were included in either pre- or post-policy study group. Antibiotic costs 16 months before compared with 26 after implementation new restrict (1) broad-spectrum when not necessary, (2) expensive agents less costly agent could be used, (3) an excessive dosage interval. Patient subgroups treated 4 further within diagnosis-related group (DRG) assignments using demographic, cost, outcome measures. results: The average monthly 26-month $7,600 than 16-month pre-policy (p conclusion: policies can developed ensure care designed select cost-effective agents. Prospective monitoring by IDS resulted significant sustained reduction without detrimental effect length deaths.