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Indirect Standardization as a Case Mix Adjustment Method to Improve Comparison of Children's Hospitals' Antimicrobial Use.
- Source :
-
Clinical Infectious Diseases . 9/1/2021, Vol. 73 Issue 5, p925-932. 8p. - Publication Year :
- 2021
-
Abstract
- Antimicrobial use (AU) in days of therapy per 1000 patient-days (DOT/1000 pd) varies widely among children's hospitals. We evaluated indirect standardization to adjust AU for case mix, a source of variation inadequately addressed by current measurements. Hospitalizations from the Pediatric Health Information System were grouped into 85 clinical strata. Observed to expected (O:E) ratios were calculated by indirect standardization and compared with DOT/1000 pd. Outliers were defined by O:E z -scores. Antibacterial DOT/1000 pd ranged from 345 to 776 (2.2-fold variation; interquartile range [IQR] 552–679), whereas O:E ratios ranged from 0.8 to 1.14 (1.4-fold variation; IQR 0.93–1.05). O:E ratios were moderately correlated with DOT/1000 pd (correlation estimate 0.44; 95% confidence interval, 0.19–0.64; P = .0009). Using indirect standardization to adjust for case mix reduces apparent AU variation and may enhance stewardship efforts by providing adjusted comparisons to inform interventions. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ANTIMICROBIAL stewardship
*RESEARCH
*CONFIDENCE intervals
*CHILDREN'S hospitals
*ANTI-infective agents
*MEDICAL cooperation
*RETROSPECTIVE studies
*RISK assessment
*BENCHMARKING (Management)
*QUALITY assurance
*DESCRIPTIVE statistics
*DATA analysis software
*LONGITUDINAL method
*HOSPITAL care of children
*STANDARDS
Subjects
Details
- Language :
- English
- ISSN :
- 10584838
- Volume :
- 73
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Clinical Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 152352865
- Full Text :
- https://doi.org/10.1093/cid/ciaa1854