title: Leveraging drug-utilization and external benchmarking data to drive change in prescribing behaviors.
abstract: OBJECTIVE
  Improved outcomes and cost savings achieved at a large hospital through a drug utilization benchmarking and reporting initiative are described.
  
  
  CONCLUSIONS
  Using the University HealthSystem Consortium (UHC) Clinical Resource Manager (CRM) database, the University of Kansas Hospital identified nine target areas (based on Medicare Severity Diagnosis-Related Group) in which the hospital's drug-utilization practices were deemed suboptimal relative to those of other UHC member facilities with similar caseloads. The pharmacy department developed a CRM template for generating customized reports comparing the hospital's performance on various drug-utilization metrics with that of top-performing peers (i.e., institutions achieving the best patient care outcomes in terms of mortality and length of stay) in the nine target areas. A pre-post comparison of drug-utilization data collected before and after implementation of the reporting initiative indicated improved outcomes in all nine initially selected target areas, with estimated cumulative annualized cost savings of about $900,000. The CRM-generated reports are now distributed semiannually to attending physicians and other hospital leaders via electronic and hard-copy means, focusing on variances from UHC top-performer and overall UHC averages in the use of higher-cost drugs. The reporting initiative has generally fostered enhanced physician-pharmacist collaboration in the investigation of identified drug-utilization variances and implementation of practice changes.
  
  
  CONCLUSIONS
  By evaluating service-specific trends of internal drug utilization against external benchmarks and emulating prescribing practices at top-performing institutions, an academic medical center has achieved improved patient care outcomes and cost savings.
authors.affiliation: Department of Pharmacy, University of Kansas Hospital, Kansas City, 66160, USA. boneal@kumc.edu
authors.forename: Brian C
authors.initials: BC
authors.lastname: O'Neal
authors.forename: Rick J
authors.initials: RJ
authors.lastname: Couldry
authors.forename: Samaneh T
authors.initials: ST
authors.lastname: Wilkinson
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Cannella
authors.forename: Casey B
authors.initials: CB
authors.lastname: Williams
authors.forename: Leigh A
authors.initials: LA
authors.lastname: Scott
authors.forename: Steven Q
authors.initials: SQ
authors.lastname: Simpson
mesh_terms: D019985:Benchmarking; D017046:Cost Savings; D003953:Diagnosis-Related Groups / Q000191:economics; D016527:Drug Costs; D004363:Drug Utilization / Q000191:economics* / Q000592:standards / Q000639:trends; D005377:Financial Management, Hospital / Q000592:standards / Q000639:trends; D017052:Hospital Mortality; D006801:Humans; D007615:Kansas; D007902:Length of Stay / Q000191:economics / Q000639:trends; D006278:Medicare / Q000191:economics* / Q000592:standards; D009096:Multi-Institutional Systems; D019982:Organizational Case Studies; D017063:Outcome Assessment, Health Care / Q000191:economics*; D010607:Pharmacy Service, Hospital / Q000191:economics* / Q000592:standards / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000592:standards / Q000639:trends; D012052:Reimbursement, Incentive; D014481:United States