Sauer Brian C, Hepler Charles D, Cherney Becky, Williamson Jacquelyn
Salt Lake City IDEAS Center (182), Veterans Affairs Salt Lake City Health Care System, 500 Foothill Dr, Salt Lake City, UT 84148, USA.
Am J Manag Care. 2007 Jan;13(1):29-35.
To computerize indicators of potential drug-related emergency department and hospital admissions and to report the incidence of these potential drug-related morbidities for a managed care organization.
Retrospective review of healthcare organizations' pharmacy and administrative claims databases.
Thirty-nine indicators were coded and were used in an automated search of claims data. The indicators of potential drug-related morbidities comprised a pattern of care and an associated adverse outcome. Poisson distribution regression analysis was performed to assess the association of patient factors with indicator positives.
The incidence densities for indicator positives were 1.96 (95% confidence interval, 1.60-2.40) per 1000 patient-years in the general population and 13.6 (95% confidence interval, 8.8-20.2) per 1000 patient-years among older persons. Age, male sex, number of medical conditions, and number of medications from different classes were associated with an increased rate of indicator positives.
Indicators of potential drug-related morbidities can be fully automated and used to search through medical and pharmacy claims. The indicators investigated in this study show promise as a quality improvement tool and should be further developed and evaluated.
将与药物相关的急诊科就诊和住院指标计算机化，并报告一家管理式医疗组织中这些潜在药物相关疾病的发生率。
对医疗保健组织的药房和行政索赔数据库进行回顾性审查。
对39项指标进行编码，并用于自动搜索索赔数据。潜在药物相关疾病的指标包括一种护理模式和一个相关的不良后果。进行泊松分布回归分析以评估患者因素与指标阳性之间的关联。
在普通人群中，指标阳性的发病密度为每1000患者年1.96（95%置信区间，1.60 - 2.40），在老年人中为每1000患者年13.6（95%置信区间，8.8 - 20.2）。年龄、男性、疾病数量和不同类别药物数量与指标阳性率增加相关。
潜在药物相关疾病的指标可以完全自动化，并用于搜索医疗和药房索赔。本研究中调查的指标有望成为一种质量改进工具，应进一步开发和评估。
