Medical Care Evaluation Study: Use of Antibiotics in Nursing Home Patients.

摘要

A medical care evaluation study was initiated by the Montgomery County (Md.) Utilization Review Committee to survey the use of antibiotics in skilled nursing facility (SNF) patients. Data collection was accomplished by randomly selecting charts of patients in SNF's who had been discharged or had expired during the 6 months preceding the study. Patient charts included in the study were Medicare, Medicaid, and private paying patients. It was found that about one-third of 600 patients in the study group received antibiotics. The median age of the patients was 78 years. Antibiotics were prescribed for approximately 90 percent of the patients because of signs and symptoms indicative of infectious disease. In 10 percent of the charts reviewed, there was no indication as to why antibiotics were prescribed. Laboratory studies performed on about 46 percent of patients receiving an antibiotic showed that the physician recorded a diagnosis at the time the drug was prescribed in 29 percent of the patients. Of all patients who received an antibiotic, 50 percent recovered from the illness for which they were being treated and 41 percent died. The ultimate outcome was not known for 9 percent of the patients. In about 68 percent of the patients who received antibiotics, the physician did see the patient for the illness. Suggestions are offered for improving the procedures involved in the conduct of a medical care evaluation study.