A cellulitis guideline at a community hospital -- we can reduce costs by standardizing care.
OBJECTIVES To assess whether there is: a) a clinical difference between patients with cellulitis treated according to the recommendations of a clinical cellulitis guideline, and those treated otherwise and b) a difference in the cost of antibiotic treatment of the two groups. METHODS Emergency Depar...
| Publicado en: | Journal of Emergency Primary Health Care Vol. 7; no. 1; pp. 12p - 13 |
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| Autores principales: | , , |
| Formato: | algorithm practice guidelines research tables/charts Journal Article |
| Publicado: |
Monash University, Department of Community Emergency Health & Paramedic Practice
2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105514330&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105514330 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14474999 1FUO jtl: Journal of Emergency Primary Health Care issn: 14474999 maglogo: N pubinfo: dt: 2009 vid: 7 iid: 1 pid: 26250 pub: Monash University, Department of Community Emergency Health & Paramedic Practice place: Clayton, Victoria, <Blank> artinfo: ui: 105514330 105514330 2010262805 105514330 ppf: 12p ppct: 1 formats: fmt: @attributes: type: P tig: atl: A cellulitis guideline at a community hospital -- we can reduce costs by standardizing care. aug: au: Campbell SG Burton-MacLeod R Howlett T affil: Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia sug: subj: Antibiotics Administration and Dosage Antibiotics Economics Cellulitis Drug Therapy Cellulitis Economics Data Analysis Software Female Guideline Adherence Hospitals, Community Nova Scotia Male Middle Age Nonexperimental Studies Nova Scotia Pilot Studies Scales Severity of Illness Severity of Illness Indices Treatment Outcomes Human Middle Aged: 45-64 years Female Male ab: OBJECTIVES To assess whether there is: a) a clinical difference between patients with cellulitis treated according to the recommendations of a clinical cellulitis guideline, and those treated otherwise and b) a difference in the cost of antibiotic treatment of the two groups. METHODS Emergency Department (ED) patients diagnosed with cellulitis at a community hospital were graded using a 4-point scale, and physicians were encouraged to treat based on an established practice guideline. Patients were contacted 5 days after their ED visit, and again at 10 days if they had not improved by 5 days. Physician 'compliance' was defined as having followed three or more of the five elements of the guideline. RESULTS Of the 272 patients, 147 (54.1%) were classified as Grade I, 53 (19.5%) Grade II, 33(12.1%) Grade III, and 6 (2.2%) Grade IV. In 12.1% the grade was not assigned. 43.5% were treated in compliance with the guidelines, of which 83.3% reported improvement at 5 days, compared to 87.7% of those treated otherwise. At 10 days, 98.8% of the patients treated in compliance with the protocol had improved compared to 94.7% of those treated otherwise. Average antibiotic cost/patient was: Grade 1: $8.48, Grade II: $16.65, Grade II: $96.53 in the 'compliance' group, and $35.68, $51.28, and $150.18 respectively in the 'non-compliance' group. CONCLUSIONS Patients treated in accordance with the cellulitis guideline had similar outcomes to those treated otherwise, at significantly lower cost. Efforts to encourage compliance with the guideline are indicated. pubtype: Academic Journal doctype: algorithm practice guidelines research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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