Drug Prescribing Quality and Length of Hospital Stay - Executive Summary and Final Report

摘要

This quasi-experimental study of the appropriateness of drug therapy involved seven acute care general hospitals in Baltimore, Maryland. A retrospective review of patient charts with diagnosis of either pyelonephritis (PY) or pneumococcal pneumonia (PN) and without concurrent medical problems, was done for the period 1974-79. A total of 133 PY cases and 183 PN cases were used. Three types of explicit prescribing criteria were employed to judge the appropriateness of prescribing (case qualifying for the study; the disease entity; and the appropriateness of a variety of aspects of drug prescribing, including choice of drug, route and dosage, length of therapy, and monitoring of drug effects). Cases were categorized as having received appropriate or inappropriate drug therapy. Differences between groups in terms of length of stay and other variables such as severity of illness, source of payment, and efficiency of care were examined. A substantial proportion of the errors made in prescribing involved the under-utilization of anti-microbial therapy (not administering it soon enough or not continuing it long enough).