Utilization of a central venous catheter insertion care bundle in Taiwan: A cross-sectional analysis of the National Health Insurance Research Database
Objectives: The objectives of this study are to explore medical care utilization associated with promoting the central venous catheter (CVC) care bundle plan using Taiwan's National Health Insurance Research Database (NHIRD). Materials and Methods: We performed a cross-sectional, secondary anal...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2019-01-01
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| Series: | Tzu Chi Medical Journal |
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| Online Access: | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2019;volume=31;issue=3;spage=182;epage=187;aulast=Chung |
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| author | Hui-Chun Chung Lih-Shinn Wang Jung-Lun Wu Tsung-Cheng Hsieh |
| author_facet | Hui-Chun Chung Lih-Shinn Wang Jung-Lun Wu Tsung-Cheng Hsieh |
| author_sort | Hui-Chun Chung |
| collection | DOAJ |
| description | Objectives: The objectives of this study are to explore medical care utilization associated with promoting the central venous catheter (CVC) care bundle plan using Taiwan's National Health Insurance Research Database (NHIRD). Materials and Methods: We performed a cross-sectional, secondary analysis of the data from patients who were admitted to a medical center for the first time between July 1, 2010, and June 30, 2012, in the NHIRD. The control group was patients who were admitted at nine medical center hospitals that participated in the pilot plan, and the study group was patients who were admitted at other ten medical center hospitals that did not participate in the pilot plan, and the differences between groups were analyzed. Results: After implementing the CVC care bundle, the average hospital stay decreased significantly (18.43 ± 12.96 vs. 15.49 ± 10.16, P < 0.05). In addition, the study group patients were clinically less likely to require antibiotics than the control group (odds ratio = 0.33, 95% confidence interval [CI] = [0.07, 1.71] vs. 0.62, 95% CI = [0.40, 0.96], P = 3768), and their medical expenses were lower (220, 618 ± 226, 419 vs. 208, 079 ± 193, 610, P > 05). Furthermore, the incidence rate of CVC-associated sepsis decreased from 12.59% to 5.66%. Conclusions: By implementing the CVC care bundle in clinical practice in accordance with national policies, medical utilization decreased, thereby considerably improving medical resource usage. These results confirmed that implementing the CVC care bundle possibly decreased medical utilization in clinical practice. |
| format | Article |
| id | doaj-art-dbbb9ecedbcd4ba38cc4cda35d76cf36 |
| institution | Kabale University |
| issn | 1016-3190 2223-8956 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Tzu Chi Medical Journal |
| spelling | doaj-art-dbbb9ecedbcd4ba38cc4cda35d76cf362025-08-20T03:24:21ZengWolters Kluwer Medknow PublicationsTzu Chi Medical Journal1016-31902223-89562019-01-0131318218710.4103/tcmj.tcmj_63_18Utilization of a central venous catheter insertion care bundle in Taiwan: A cross-sectional analysis of the National Health Insurance Research DatabaseHui-Chun ChungLih-Shinn WangJung-Lun WuTsung-Cheng HsiehObjectives: The objectives of this study are to explore medical care utilization associated with promoting the central venous catheter (CVC) care bundle plan using Taiwan's National Health Insurance Research Database (NHIRD). Materials and Methods: We performed a cross-sectional, secondary analysis of the data from patients who were admitted to a medical center for the first time between July 1, 2010, and June 30, 2012, in the NHIRD. The control group was patients who were admitted at nine medical center hospitals that participated in the pilot plan, and the study group was patients who were admitted at other ten medical center hospitals that did not participate in the pilot plan, and the differences between groups were analyzed. Results: After implementing the CVC care bundle, the average hospital stay decreased significantly (18.43 ± 12.96 vs. 15.49 ± 10.16, P < 0.05). In addition, the study group patients were clinically less likely to require antibiotics than the control group (odds ratio = 0.33, 95% confidence interval [CI] = [0.07, 1.71] vs. 0.62, 95% CI = [0.40, 0.96], P = 3768), and their medical expenses were lower (220, 618 ± 226, 419 vs. 208, 079 ± 193, 610, P > 05). Furthermore, the incidence rate of CVC-associated sepsis decreased from 12.59% to 5.66%. Conclusions: By implementing the CVC care bundle in clinical practice in accordance with national policies, medical utilization decreased, thereby considerably improving medical resource usage. These results confirmed that implementing the CVC care bundle possibly decreased medical utilization in clinical practice.http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2019;volume=31;issue=3;spage=182;epage=187;aulast=ChungCentral venous catheter-associated sepsisCentral venous catheter care bundleNational health insurance research databasePatients' length of stayUse of medical resources |
| spellingShingle | Hui-Chun Chung Lih-Shinn Wang Jung-Lun Wu Tsung-Cheng Hsieh Utilization of a central venous catheter insertion care bundle in Taiwan: A cross-sectional analysis of the National Health Insurance Research Database Tzu Chi Medical Journal Central venous catheter-associated sepsis Central venous catheter care bundle National health insurance research database Patients' length of stay Use of medical resources |
| title | Utilization of a central venous catheter insertion care bundle in Taiwan: A cross-sectional analysis of the National Health Insurance Research Database |
| title_full | Utilization of a central venous catheter insertion care bundle in Taiwan: A cross-sectional analysis of the National Health Insurance Research Database |
| title_fullStr | Utilization of a central venous catheter insertion care bundle in Taiwan: A cross-sectional analysis of the National Health Insurance Research Database |
| title_full_unstemmed | Utilization of a central venous catheter insertion care bundle in Taiwan: A cross-sectional analysis of the National Health Insurance Research Database |
| title_short | Utilization of a central venous catheter insertion care bundle in Taiwan: A cross-sectional analysis of the National Health Insurance Research Database |
| title_sort | utilization of a central venous catheter insertion care bundle in taiwan a cross sectional analysis of the national health insurance research database |
| topic | Central venous catheter-associated sepsis Central venous catheter care bundle National health insurance research database Patients' length of stay Use of medical resources |
| url | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2019;volume=31;issue=3;spage=182;epage=187;aulast=Chung |
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