Development of BC2017 Tool to Process KPIs Information of Antibiotic Smart Use In the 15th Health Service Plan

Abstract

Objective: This study is research for development of BC2017, a tool for processing key performance indexes (KPIs) in antibiotic smart use for upper respiratory infection and acute bronchitis (URI-AB) in outpatients and acute diarrhea (AD) as indicated in ICD-10 according to 15th health service plan. Methods: BC2017 was developed in this study by LibreOffice program to process the relations of service data obtained from the following 11 out of 43 folders of standard hospital information system--PERSON, SERVICE, ADMISSION, ANC, DRUGALLERGY, DIAGNOSIS_IPD, DIAGNOSIS_OPD, DRUG_OPD, DRUG_IPD, PROCEDURE_IPD, and PROCEDURE_OPD. The study identified antibiotic uses by ATC codes J01, and analyze the relations between disease codes and criterion for acceptable antibiotic use approved by 8 physicians and pharmacists. Pilot test of the BC2017 was conducted in 10 hospitals. Results: The tool was able to analyze KPIs for antibiotic use in URI-AB and AD, gaining the result comparable to that obtained from the previous analysis in each hospital. However, the tool had additional capability to calculate supplemental KPIs and search for qualitative data developed in the study. Results from the tool showed multiple service utilization of patients with URI-AB within one months, and data categorized by risk factors including age more than 70 years old, pregnancy, fever with temperature over 38 degrees Celsius, comorbidities (HIV, neutropenia) of patients with AD. The BC2017 also detected patients with potential drug related problems, for example, matching between drugs and indications in a particular disease code, results on physical examination or personal condition in the date receiving services that may affect treatment plan. However, the tool can only process the data with no more than 30,000 records. Conclusion: The BC2017 could process the information for the KPIs on rational antibiotic use of infectious disease specified in the service plan, help processing quantitative data to provide the detail of the problems. Additionally, the tool can be used to monitor drug prescribing together with the processing others KPIs in the health service plan such as drug related problems.