DOES ACCEPTING PHARMACOKINETIC RECOMMENDATIONS IMPACT HOSPITALIZATION - A COST-BENEFIT-ANALYSIS

被引:46
作者
DESTACHE, CJ
MEYER, SK
ROWLEY, KM
机构
[1] AMI ST JOSEPH HOSP,CLIN PHARMACOKINET SERV,OMAHA,NE
[2] AMI ST JOSEPH HOSP,CLIN PHARM SERV,OMAHA,NE
关键词
Aminoglycosides; Cost justification of clinical service; Cost-benifit; Pharmacokinetic service;
D O I
10.1097/00007691-199009000-00004
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
In a prospective, randomized study, 110 adults receiving aminogly-cosides were randomized to follow-up by a clinical pharmacokinetic service (CPS). Of the 110 patients, 35 accepted pharmacokinetic recommendations less than 100% of the time. The two groups were similar in age, sex, height, APACHE II score, and initial creatinine clearance. A cost-to-charge ratio was used to derive direct costs of hospitalization and calculate cost-benefit. Patients whose physicians accepted pharmacokinetic recommendations 100% of the time had shorter hospitalizations (322.67 ± 270.28 h; CPS < 100%, 699.54 ± 806.35; p = 0.001) and febrile periods (50.05 ± 79.38 h; CPS < 100%, 120.00 ± 153.23; p = 0.002). Acceptance of CPS recommendations led to adequate peak levels. Acceptance of CPS recommendations led to lower direct costs (7,102.56 ± 9,898.19; CPS < 100%, 19,629.94 ± 28,051.89; p < 0.001). Calculated direct cost of the service was 85/patient. © 1990 Raven Press, Ltd., New York.
引用
收藏
页码:427 / 433
页数:7
相关论文
共 22 条
[1]  
[Anonymous], STATISTICAL PACKAGE
[2]   INDIVIDUALIZING GENTAMICIN DOSAGE REGIMENS IN BURN PATIENTS WITH GRAM-NEGATIVE SEPTICEMIA - COST-BENEFIT-ANALYSIS [J].
BOOTMAN, JL ;
WERTHEIMER, AI ;
ZASKE, D ;
ROWLAND, C .
JOURNAL OF PHARMACEUTICAL SCIENCES, 1979, 68 (03) :267-272
[3]   COST OF INDIVIDUALIZING AMINOGLYCOSIDE DOSAGE REGIMENS [J].
BOOTMAN, JL ;
ZASKE, DE ;
WERTHEIMER, AI ;
ROWLAND, C .
AMERICAN JOURNAL OF HOSPITAL PHARMACY, 1979, 36 (03) :368-370
[4]   POSITIVE IMPACT OF A THERAPEUTIC DRUG-MONITORING PROGRAM ON TOTAL AMINOGLYCOSIDE DOSE AND COST OF HOSPITALIZATION [J].
CRIST, KD ;
NAHATA, MC ;
ETY, J .
THERAPEUTIC DRUG MONITORING, 1987, 9 (03) :306-310
[5]   IMPACT OF A CLINICAL PHARMACOKINETIC SERVICE ON PATIENTS TREATED WITH AMINOGLYCOSIDES FOR GRAM-NEGATIVE INFECTIONS [J].
DESTACHE, CJ ;
MEYER, SK ;
PADOMEK, MT ;
ORTMEIER, BG .
DICP-THE ANNALS OF PHARMACOTHERAPY, 1989, 23 (01) :33-38
[6]   INFLUENCE OF CLINICAL PHARMACIST CONSULTATIONS ON THE USE OF DRUG BLOOD LEVEL TESTS [J].
ELENBAAS, RM ;
PAYNE, VW ;
BAUMAN, JL .
AMERICAN JOURNAL OF HOSPITAL PHARMACY, 1980, 37 (01) :61-64
[7]   PHARMACOKINETICS OF GENTAMICIN - DISTRIBUTION AND PLASMA AND RENAL CLEARANCE [J].
GYSELYNCK, AM ;
FORREY, A ;
CUTLER, R .
JOURNAL OF INFECTIOUS DISEASES, 1971, 124 (DEC) :S70-+
[8]  
HURST AK, 1987, CLIN PHARMACY, V6, P234
[9]  
JELLIFFE R W, 1972, Mathematical Biosciences, V14, P17, DOI 10.1016/0025-5564(72)90003-X
[10]  
JELLIFFE RW, 1986, TOPICS CLIN PHARM TH, P26