Inter-hospital variation in the utilization of diagnostics and their proportionality in the management of adult community-acquired pneumonia

Utilization of diagnostics and biomarkers are the second largest cost drivers in the management of patients hospitalized with community-acquired pneumonia (CAP). The present study aimed to systematically assess the inter-hospital variation in these cost drivers in relation to antibiotic use in CAP....

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Bibliographic Details
Published in:Pneumonia 2018-12, Vol.10 (1), p.15-5, Article 15
Main Authors: Vestjens, Stefan M T, Wittermans, Esther, Spoorenberg, Simone M C, Grutters, Jan C, van Ruitenbeek, Charlotte A, Voorn, G Paul, Bos, Willem Jan W, van de Garde, Ewoudt M W
Format: Article
Language:English
Subjects:
Abdomen
Antibiotics
Antigens
Antimicrobial agents
Antimicrobial stewardship
Brief Report
Choosing wisely
Community-acquired pneumonia
Costs
Costs and cost analysis
Creatinine
Hybridization
Intensive care
Microbiological testing
Pathogens
Patients
Pneumonia
Polymerase chain reaction
Potassium
Streptococcus infections
Ultrasonic imaging
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Summary:Utilization of diagnostics and biomarkers are the second largest cost drivers in the management of patients hospitalized with community-acquired pneumonia (CAP). The present study aimed to systematically assess the inter-hospital variation in these cost drivers in relation to antibiotic use in CAP. Detailed resource utilization data from 300 patients who participated in a multicenter placebo-controlled trial investigating dexamethasone as adjunctive treatment for community-acquired pneumonia was grouped into 3 categories: clinical chemistry testing, radiological exams, and microbiological testing. Based on the identified top 5 items per category, average costs were calculated per category and per hospital. Antibiotic de-escalation at day 3 and secondary ICU admission were assessed as outcomes for proportionality of diagnostics use. The mean costs for diagnostics varied between hospitals from 350 (SD 31) to 841 (SD 37) euro per patient (  
ISSN:2200-6133
2200-6133
DOI:10.1186/s41479-018-0059-0