The Association between Guideline Adherence for Using Antibiotics Prophylaxis in Cesarean Section and Health Care Outcomes and Expenditure
Date Issued
2011
Date
2011
Author(s)
Lin, Shu-Wei
Abstract
Background and objectives: Using antibiotics prophylaxis has been proven to be effective in reducing the incidence of surgical site infections. Although several guidelines for using antibiotics prophylaxis have been published in past decades, the implementation of these guidelines is unsatisfactory. The main purpose of this study is to understand the status of adherence to guidelines, introduced in 2004, for using antibiotics prophylaxis in cesarean section in Taiwan and to evaluate the association between guideline adherence and health care outcomes.
Method: This study used claims data file of 1 million sampled registry from Taiwan National Health Insurance Research Database. A total of 8,518 cesarean sections from 2005 to 2007 were included in the study. Logistic regression and multiple linear regression were used to test the relationships between guideline adherence and characteristics of health care providers, and to examine the association between guideline adherence and health care outcomes.
Results: Of the 8,518 procedures, the guideline adherence rate was 19.58%; the average use of antibiotics prophylaxis is 2.11 types for each of the births, and the most frequently prescribed antibiotics were first-generation cephalosporins. Births in non-adherence group had significantly higher surgical site infection rate within seven days after discharge and had higher drugs cost and medical expenditure.
Conclusion: The study showed that adherence to guideline in cesarean section had better health care outcomes. Although the guideline adherence of antibiotics prophylaxis is improving in Taiwan, it still has lots of space for improvement. Therefore, the authorities should make policy according to the health care providers’ characteristics to improve the guideline adherence of antibiotics prophylaxis in cesarean section.
Subjects
cesarean section
surgical site infection
antibiotics prophylaxis
guideline adherence
Type
thesis
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