The CEI is a sophisticated integrated analysis of data from commonly available sources that addresses this question: Did the use of a new medication (e.g., LMWH) increase or decrease the overall cost of caring for inpatients who received it compared with similar patients who received an older medication (e.g., UFH)?
A Comparison of Actual and Expected Treatment Rates Because the CEI involved multiple hospitals, the data were pooled and used for comparison with treatment patterns at individual hospitals. These comparisons were adjusted to the case mix for each hospital to allow the individual hospital to be compared with the pooled data. To accomplish this, the [...]
Case Mix Adjusted Savings Achieved Savings Savings calculated at the CEI-DRG level were summed by patient category. Savings per case in each CEI-DRG could not be simply summed to provide an overall savings estimate for a patient category. A weighted average was needed that reflected the case mix of patients receiving the drugs. Because the [...]
Data Editing and Outlier Identification To help ensure the credibility of the results, data used in the CEI were subjected to a series of steps involving screening, edits, and measures to identify outliers (data values that stand out from others in a set).
Mix Measurement Comparing the effects of two drugs on patient-care costs and outcomes requires adjusting for differences in the clinical conditions of patients. The CEI started with the standard Diagnosis-Related Groups (DRGs), which are used nationally in the Medicare Prospective Payment System (PPS). Modifications were made to tailor these DRGs to the needs of the [...]
BACKGROUND AND NEED Contemporary issues facing institutional managers, as well as P&T committee members, focus heavily on balancing patient care costs and outcomes. That balance should assist organizations in achieving their value propositions in providing optimal patient care—in this case, through the appropriate use of pharmaceutical agents. Achieving a balance requires informed decision-making along with [...]
