title: Development of a best-practice model at a university hospital to increase efficiency in the management of patients with community-acquired pneumonia.
abstract: An economic evaluation of drug acquisition, nursing care, pharmacy time, laboratory costs, supplies, and ancillary care was conducted as a first step toward developing a pneumonia management plan at the University of Kentucky Medical Center (UKMC). UKMC costs were compared with costs at other hospitals treating pneumonia patients on Medicare. Overall costs for pneumonia at the 25% of hospitals nationwide with the lowest costs for Medicare patients with this condition were determined and compared with costs at UKMC. Against nationwide benchmarks, efficiencies at UKMC for treating simple pneumonia ranged from 45% for pharmacy expenses to 81% for nursing costs. Efficiencies for complicated pneumonia ranged from 47% for laboratory costs to 67% for nursing costs. The most cost-efficient antimicrobial treatment options were promoted and integrated into a pneumonia management plan based on Infectious Diseases Society of America treatment guidelines. A comparison of pneumonia treatment costs at UKMC with those at the 25% of hospitals nationwide with the lowest treatment costs for Medicare patients with pneumonia revealed that UKMC pharmacy costs could be optimized. Strategies for standardizing the care of patients with community-acquired pneumonia (CAP) are being implemented.
authors.affiliation: Division of Pharmacy Practice, University of Kentucky College of Pharmacy (UKCP), Lexington 40536-0293, USA. mharp1@pop.uky.edu
authors.forename: M L
authors.initials: ML
authors.lastname: Gora-Harper
authors.forename: R P
authors.initials: RP
authors.lastname: Rapp
authors.forename: J P
authors.initials: JP
authors.lastname: Finney
mesh_terms: D000046:Academic Medical Centers; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D019985:Benchmarking; D017714:Community-Acquired Infections / Q000191:economics / Q000628:therapy; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups; D019468:Disease Management; D016527:Drug Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007629:Kentucky; D007902:Length of Stay; D006278:Medicare / Q000191:economics; D010348:Patient Care Team; D011014:Pneumonia / Q000191:economics* / Q000628:therapy*; D012720:Severity of Illness Index; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents