Alhiary, Rasha
(2023)
The Impact of Documented Antibiotic Allergies in Electronic Health Records on Medical and Pharmacy Costs.
Master's Thesis, University of Pittsburgh.
(Unpublished)
Abstract
Objective: Previous studies estimated costs attributable to beta-lactam allergies using health system-specific hospital charges or relied on statistical models and tests that did not account for the unique characteristics of health care cost data. Other studies suggested a potential increase in health care costs due to beta-lactam allergies based on conclusions drawn from clinical outcomes rather than actual cost analyses. To the best of our knowledge, no studies estimated costs attributable to non-beta-lactam allergy labels. Our objective was to determine whether documented beta-lactam allergies were associated with increased medical and pharmacy costs compared to documentation of no allergy. We also sought to determine whether documented non-beta-lactam allergies might be similarly associated with increased medical and pharmacy costs. Methods: Adult patients admitted to a regional health system in Western Pennsylvania with documented allergy information and a diagnosis of sepsis, pneumonia, or urinary tract infection (UTI) were identified from 01/01/2007 through 12/31/2008. Our outcomes of interest were medical and pharmacy costs. We used a two-part model to study the association between allergy status and medical and pharmacy costs: the first part created a subset of patients with non-zero costs and the second part used a generalized linear model (GLM) with log-link and gamma distribution to estimate the effect of allergy status on non-zero medical and pharmacy costs. We adjusted for covariates including age, sex, race, and diagnosis. Results: A total of 9,256 patients met the inclusion criteria as follows: 1,621 patients with documented beta-lactam allergy, 502 with documented non-beta-lactam allergies, and 7,133 with a documentation of no allergy. Patients with documented beta-lactam allergy incurred medical and pharmacy costs that were 21% higher (95% CI, 1.01 – 1.46) compared to patients with documentation of no allergy. Patients with documented non-beta-lactam allergy incurred medical and pharmacy costs that were 39% higher (95% CI, 1.02 - 1.89) compared to patients with documentation of no allergy. Conclusion: Patients with documented beta-lactam or non-beta-lactam allergies incurred more medical and pharmacy costs compared to patients with documentation of no allergy. Reassessment of erroneous antibiotic allergy labels in EHRs is important to mitigate unnecessary health care spending.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
11 August 2023 |
| Date Type: |
Publication |
| Defense Date: |
11 July 2023 |
| Approval Date: |
11 August 2023 |
| Submission Date: |
11 August 2023 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
64 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Pharmacy > Pharmaceutical Sciences |
| Degree: |
MS - Master of Science |
| Thesis Type: |
Master's Thesis |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Beta-lactam allergy, non-beta-lactam allergy, antibiotic allergies, allergy label, health care cost analysis, generalized linear model |
| Date Deposited: |
11 Aug 2023 19:44 |
| Last Modified: |
11 Aug 2023 19:44 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/45301 |
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