Impact of Guidelines on Outcome: The Evidence

被引:29
作者
Martinez, Raquel [1 ,2 ,3 ]
Reyes, Soledad [1 ]
Lorenzo, Jose [1 ]
Menendez, Rosario [1 ,2 ]
机构
[1] Hosp Univ Fe, Serv Neumol, Valencia 46009, Spain
[2] CIBERES, Valencia, Spain
[3] Autonomous Univ Barcelona, Dept Med Doctoral Programme, Barcelona, Spain
关键词
Mortality; stability; cost-effectiveness; treatment failure; pathway; COMMUNITY-ACQUIRED PNEUMONIA; ANTIBIOTIC-THERAPY; MEDICAL OUTCOMES; HOSPITAL STAY; ADHERENCE; CARE; MANAGEMENT; PHYSICIANS; QUALITY; PATIENT;
D O I
10.1055/s-0029-1202936
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Pneumonia continues to be the main cause of death due to infection in the world, and it produces a high. consumption of healthcare resources. The guidelines established by the scientific societies improve the care of patients with pneumonia. One way of evaluating the effect of the guidelines is to analyze their impact on the prognosis of the infection. To evaluate this effect, cohort studies have been performed using before-after, observational, cost-effectiveness, and, to a lesser degree, randomized designs. The most recent studies show that the implementation of the guidelines is accompanied by an increase in the process of care percentage and a lower inpatient hospital mortality rate-including the first 48 hours and after 30 days. These findings are consistent across various studies, and they have been confirmed in patients admitted to the intensive care unit. Clinical stability is also reached earlier In patients hospitalized for community-aquired pneumonia (CAP) when the antibiotic treatment is begun early and complies with the recommendations. Finally, the choice of antibiotics that adhere to the guidelines is cost-effective in CAP requiring hospitalization, which is responsible for 80% of the total cost of this disease.
引用
收藏
页码:172 / 178
页数:7
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