Correlation between case mix index and antibiotic use in hospitals
Open accessAbstract
BACKGROUND: To compare the quantitative antibiotic use between hospitals or hospital units and to explore differences, adjustment for severity of illness of hospitalized patients is essential. The case mix index (CMI) is an economic surrogate marker (i.e. the total cost weights of all inpatients per a defined time period divided by the number of admissions) to describe the average patients' morbidity of individual hospitals. We aimed to investigate the correlation between CMI and hospital antibiotic use. METHODS: We used weighted linear regression analysis to evaluate the correlation between in-hospital antibiotic use in 2006 and CMI of 18 departments of the tertiary care University Hospital Zurich and of 10 primary and 2 secondary acute care hospitals in the Canton of Zurich in Switzerland. RESULTS: Antibiotic use varied substantially between different departments of the university hospital [defined daily doses (DDD)/100 bed-days, 68.04; range, 20.97-323.37] and between primary and secondary care hospitals (range of DDD/100 bed-days, 15.45-57.05). Antibiotic use of university hospital departments and the different hospitals, respectively, correlated with CMI when calculated in DDD/100 bed-days [coefficient of determination (R(2)), 0.57 (P = 0.0002) and 0.46 (P = 0.0065)], as well as when calculated in DDD/100 admissions [R(2), 0.48 (P = 0.0008) and 0.85 (P < 0.0001), respectively]. CONCLUSIONS: Antibiotic use correlated with CMI across various specialties of a university hospital and across different acute care hospitals. For benchmarking antibiotic use within and across hospitals, adjustment for CMI may be a useful tool in order to take into account the differences in hospital category and patients' morbidities.
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The case mix index (CMI) is an averaged score of DRG weights given a patient group.
“we adopted the notion of the CMI3,25, which is an averaged score of DRG weights given a patient group.”
From Early prediction of diagnostic-related groups and estimation of hospital cost by processing clinical notes (2021) · cites this paper as [25]
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- Authors
- Kuster, S. P., Ruef, C., Bollinger, A. K., Ledergerber, B., Hintermann, A., Deplazes, C., Neuber, L., & Weber, R.
- Affiliations
- University Hospital Zurich (CH)
- Kanton Zürich (CH)
- Corresponding author
- Weber, R.
- Venue
- Journal of Antimicrobial Chemotherapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-06-27
- Volume
- 62
- Issue
- 4
- Pages
- 837-842
- ISSN
- 0305-7453 (ISSN-L)
- 1460-2091
- OpenAlex
- W2125280861
- Cited by
- 90
- References
- 31
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 6 · 2022: 2 · 2021: 7 · 2020: 2 · 2019: 7 · 2018: 6 · 2017: 3 · 2016: 6 · 2015: 6 · 2014: 5 · 2013: 6 · 2012: 3
- FWCI
- 9.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Antimicrobial Chemotherapy (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
- reroDoc Digital Library (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Medicine › Surgery › Surgical site infection prevention
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Keywords
- case mix index, antibiotic use, hospital benchmarking, defined daily doses, hospital departments, hospital morbidity
- MeSH terms
- Anti-Bacterial Agents, Drug Utilization, Hospitals, Statistics as Topic, Switzerland, Linear Models, Risk Adjustment
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