Cost Analysis of Computerized Clinical Decision Support and Trainee Financial Incentive for Clostridioides difficile Testing

Improving test utilization through diagnostic stewardship has the potential to reduce unnecessary testing and diagnostic error.4 Various strategies have been proposed for C. difficile testing, including computerized clinical decision support (CCDS).4 We previously reported implementation of a CCDS t...

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Veröffentlicht in:Infection control and hospital epidemiology Jg. 40; H. 2; S. 242 - 244
Hauptverfasser: Madden, Gregory R., Cox, Heather L., Poulter, Melinda D., Lyman, Jason A., Enfield, Kyle B., Sifri, Costi D.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Cambridge University Press 01.02.2019
Schlagworte:
Antibiotics
Clinical decision making
Clostridium difficile - isolation & purification
Clostridium Infections - diagnosis
Clostridium Infections - economics
Cost analysis
Cost control
Costs and Cost Analysis
Cross Infection - diagnosis
Cross Infection - economics
Decision Support Systems, Clinical - economics
Education, Medical, Graduate
Feces - microbiology
Hospitals
Humans
Infections
Intervention
Laboratories
Medical Overuse - prevention & control
Monetary incentives
Patient safety
Physician Incentive Plans - economics
Quality improvement
Retrospective Studies
Virginia
Virginia
ISSN:0899-823X, 1559-6834, 1559-6834
Online-Zugang:Volltext
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Zusammenfassung:Improving test utilization through diagnostic stewardship has the potential to reduce unnecessary testing and diagnostic error.4 Various strategies have been proposed for C. difficile testing, including computerized clinical decision support (CCDS).4 We previously reported implementation of a CCDS tool (as part of a multifaceted bundle of interventions to reduce National Healthcare Safety Network (NSHN)–defined hospital-onset CDI [HO-CDI])5 in our institution that led to significantly reduced testing and fewer HO-CDI events.6 Here, we present a cost analysis of this intervention. [...]HO-CDI events were chosen as a convenient estimate for reduction in treatment for CDI; however, reductions in HO-CDI did not necessarily reflect prevention of CDI treatment in all patients and may have over- or underestimated savings. [...]pharmaceutical costs were not calculated separately from estimated attributable costs because nearly all patients were treated with oral vancomycin compounded by the hospital pharmacy.
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ISSN:0899-823X
1559-6834
1559-6834
DOI:10.1017/ice.2018.300