Development of the predicted and standardized carbapenem usage metric: Analysis of the Japanese Diagnosis Procedure Combination payment system data

Maeda, Masako; Anno, Yuka; Sawa, Akihiro; Kusama, Yoshiki; Ishikane, Masahiro; Ohmagari, Norio; Ohge, Hiroki

doi:10.1016/j.jiac.2020.02.006

Cited by 5 publications

(3 citation statements)

References 10 publications

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“…Detecting the specific associated factors in carbapenem consumption would be difficult, considering the similar medical functions and inpatient backgrounds in these hospitals. Meanwhile, respiratory diseases (MDC4) and hematologic diseases (MDC13) were significantly associated with the increment of carbapenem consumption in community hospitals consistent with the previous study [ 32 ]. Rhodes et al revealed the predictors of carbapenem consumption across North American hospitals [ 33 ].…”

Section: Discussionsupporting

confidence: 89%

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Association between Carbapenem Consumption and Clinical Outcomes in an In-Hospital Setting: Analysis of a Japanese Nationwide Administrative Database in 2020

2022

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This study aimed to clarify the relationship between carbapenem consumption and clinical outcome using the diagnosis procedure combination (DPC) payment system database (2020) published by the Ministry of Health, Labour, and Welfare of Japan. This study divided 5316 medical facilities subject to aggregation into five facilities and calculated the median values, including facility characteristics, clinical outcomes, and carbapenem consumption. Next, a correlation analysis was performed between carbapenem consumption and clinical outcome, as well as a multiple regression analysis between carbapenem consumption as the dependent variable and clinical outcome, bed size, and proportion of patients by disease as independent variables. Additionally, three clinical outcomes available from the DPC payment system database were selected, including cure, readmission within 4 weeks, and the average length of stay. This study revealed no relationship between carbapenem consumption and clinical outcome in university hospitals and university hospital-equivalent community hospitals; however, a relationship was suggested in the community, DPC-prepared, and non-DPC hospitals. University hospitals and university hospital-equivalent community hospitals with a high consumption of carbapenems may need to reconsider the classification because of the limited number of facilities in this classification.

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Section: Discussionsupporting

confidence: 89%

“…Our previous DPC database analysis revealed that various MDCs were significantly associated with an increment in carbapenem consumption [ 32 ]. The stratification result by facility type in this study revealed a few associated factors in university hospitals and university hospital-equivalent community hospitals.…”

Section: Discussionmentioning

confidence: 99%

Association between Carbapenem Consumption and Clinical Outcomes in an In-Hospital Setting: Analysis of a Japanese Nationwide Administrative Database in 2020

2022

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“…Ideally, antibiotic use metrics should evaluate antimicrobial use appropriateness or standardization [ 28 , 29 , 30 ]. The standardized antimicrobial administration ratio (SAAR), which was risk-adjusted for hospital-level and unit-level factors, has been implemented as a standardized benchmark of antibiotic use in the United States, although conventional metrics could not be quantitatively evaluated for appropriateness [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Days of Antibiotic Spectrum Coverage Trends and Assessment in Patients with Bloodstream Infections: A Japanese University Hospital Pilot Study

et al. 2022

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The antibiotic spectrum is not reflected in conventional antimicrobial metrics. Days of antibiotic spectrum coverage (DASC) is a novel quantitative metric for antimicrobial consumption developed with consideration of the antibiotic spectrum. However, there were no data regarding disease and pathogen-specific DASC. Thus, this study aimed to evaluate the DASC trend in patients with bloodstream infections (BSIs). DASC and days of therapy (DOT) of in-patients with positive blood culture results during a 2-year interval were evaluated. Data were aggregated to calculate the DASC, DOT, and DASC/DOT per patient stratified by pathogens. During the 2-year study period, 1443 positive blood culture cases were identified, including 265 suspected cases of contamination. The overall DASC, DASC/patient, DOT, DOT/patient, and DASC/DOT metrics were 226,626; 157.1; 28,778; 19.9; and 7.9, respectively. A strong correlation was observed between DASC and DOT, as well as DASC/patient and DOT/patient. Conversely, DASC/DOT had no correlation with other metrics. The combination of DASC and DOT would be a useful benchmark for the overuse and misuse evaluation of antimicrobial therapy in BSIs. Notably, DASC/DOT would be a robust metric to evaluate the antibiotic spectrum that was selected for patients with BSIs.

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Relationship between carbapenem use and major diagnostic category in curative care beds: Analysis of a 2020 Japanese national administrative database

Yamaguchi,

Maeda,

Ohmagari

et al. 2024

Journal of Infection and Chemotherapy

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Development of the predicted and standardized carbapenem usage metric: Analysis of the Japanese Diagnosis Procedure Combination payment system data

Cited by 5 publications

References 10 publications

Association between Carbapenem Consumption and Clinical Outcomes in an In-Hospital Setting: Analysis of a Japanese Nationwide Administrative Database in 2020

Association between Carbapenem Consumption and Clinical Outcomes in an In-Hospital Setting: Analysis of a Japanese Nationwide Administrative Database in 2020

Days of Antibiotic Spectrum Coverage Trends and Assessment in Patients with Bloodstream Infections: A Japanese University Hospital Pilot Study

Relationship between carbapenem use and major diagnostic category in curative care beds: Analysis of a 2020 Japanese national administrative database

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