J Am Med Inform Assoc - Immediate financial impact of computerized clinical decision support for long-term care residents with renal insufficiency: a case study.

Tópicos

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Resumo

In a randomized trial of a clinical decision support system for drug prescribing for residents with renal insufficiency in a large long-term care facility, analyses were conducted to estimate the system's immediate, direct financial impact. We determined the costs that would have been incurred if drug orders that triggered the alert system had actually been completed compared to the costs of the final submitted orders and then compared intervention units to control units. The costs incurred by additional laboratory testing that resulted from alerts were also estimated. Drug orders were conservatively assigned a duration of 30 days of use for a chronic drug and 10 days for antibiotics. It was determined that there were modest reductions in drug costs, partially offset by an increase in laboratory-related costs. Overall, there was a reduction in direct costs (US$1391.43, net 7.6% reduction). However, sensitivity analyses based on alternative estimates of duration of drug use suggested a reduction as high as US$7998.33 if orders for non-antibiotic drugs were assumed to be continued for 180 days. The authors conclude that the immediate and direct financial impact of a clinical decision support system for medication ordering for residents with renal insufficiency is modest and that the primary motivation for such efforts must be to improve the quality and safety of medication ordering.

Resumo Limpo

random trial clinic decis support system drug prescrib resid renal insuffici larg longterm care facil analys conduct estim system immedi direct financi impact determin cost incur drug order trigger alert system actual complet compar cost final submit order compar intervent unit control unit cost incur addit laboratori test result alert also estim drug order conserv assign durat day use chronic drug day antibiot determin modest reduct drug cost partial offset increas laboratoryrel cost overal reduct direct cost us net reduct howev sensit analys base altern estim durat drug use suggest reduct high us order nonantibiot drug assum continu day author conclud immedi direct financi impact clinic decis support system medic order resid renal insuffici modest primari motiv effort must improv qualiti safeti medic order

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