著者
Tatsuya Aoki Hajime Yamazaki Tadayuki Hashimoto Ryosuke Horitani Shunichi Fukuhara
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.6795-20, (Released:2021-06-19)
参考文献数
21

Objective The establishment of a department of general internal medicine (GIM) has been shown to improve the clinical outcomes among patients treated in GIM departments but the effect on practice patterns in other departments remains unclear. We evaluated the association between the establishment of a GIM department and the use of blood cultures, an indicator of quality of care of infectious diseases, in other departments. Methods This study was conducted between 2013 and 2017 in a community hospital which established a new GIM department in 2015, with a mandate to improve the quality of care of the hospital including infectious disease management. The primary outcome was the change in the number of blood culture episodes per calendar month in other departments before and after establishment of the GIM department. The secondary outcome was the change in the blood culture episodes per month, indexed to 1,000 patient-days, during the same time. Using 2015 as the phase-in period, interrupted time series analyses were used to evaluate the change in the outcome variables. Results In departments other than GIM, there were 284 blood cultures prior to the establishment of the GIM department (2013-2014) and 853 afterwards (2016-2017). The number of blood culture episodes in other departments increased by 10.7 (95%CI: 0.39-21.0, p=0.042) per calendar month after the establishment of the GIM department; blood culture episodes / calendar month / 1,000 patient-days increased by 0.55 (95%CI: 0.03-1.07 p=0.037). Conclusion These results indicate that a GIM department in a community hospital can improve the quality of care in other departments.

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#論文 橋本市民病院から。総合内科設立の前後で、他科の医師が独立してオーダーした血液培養取得率がより適正になったと。Interrupted time-series analysisを使用した解析。病院総合診療医を考える上でこういう研究が今後ももっと出てきてほしいですね。https://t.co/5GEiybGwCw
総合内科の設立が院内の活動(教育やコンサルテーション)を通じて他科の血液培養採取率の改善と関連したことをInterrupted Time Series Analysisで示した単施設研究。総合内科×病院の医療の質改善研究ですね。@tadayuki0007先生publishおめでとうございます! https://t.co/vwKdXNDTpe

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