Cefdinir is associated with Lower Hospital Readmission Rates for Pneumonia Patients at Florida Hospital Orlando based on Real World Evidence Study of Medicare Claims Data

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In Cefdinir, Pneumonia

Background:

Pneumonia is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payers such as CMS’s Star Rating Program, HRRP and Value-Based Purchasing. Cefdinir is an antibiotic that is used to treat many different types of infections caused by bacteria. Studies have shown that cefdinir is effective and safe when treating patients with pneumonia.

Dexur’s analysis of Real-World Evidence based on Medicare Claims data showed that the use of Cefdinir within 7 days of hospitalization was associated with lower hospital readmission rates for Pneumonia at Florida Hospital Orlando in Orlando, Florida. Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis. Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of Drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.

Methods:

We conducted a retrospective study using Dexur’s analysis of Real-World Evidence from Medicare Claims data, for hospitalizations at Florida Hospital Orlando between January 2017 to September 2019. Our methodology criteria was as follows:

1. Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Pneumonia codes (Listed in table below)

2. Stratified Selected population into cohorts

   1. Pneumonia patients who dispensed Cefdinir within 7 Days of Hospitalization using Part D drugs claims database

   2. Pneumonia patients who did not dispense Cefdinir within 7 Days of Hospitalization

3. 30 Day readmission rates were analyzed for both population cohorts

Results:

Overall, Cefdinir was associated with lower hospital readmission rates for all Primary ICD Diagnosis Codes examined at Florida Hospital Orlando. For patients whose primary ICD Diagnosis was “Pneumonia, unspecified organism” (J189) and when Cefdinir was used within 7 days of hospitalization, the readmission rate was 15.15% compared to the cohort where Cefdinir was not used, whose readmission rate was 20.29%. The readmission odds ratio for these cohorts was 0.70. The use of Cefdinir was associated with a 30% lower readmission rate when used within 7 days of hospitalization. The full list of studied ICD codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with Cefdinir for Pneumonia hospitalizations at Florida Hospital Orlando is shown below.

Primary ICD/ICD Diagnosis Code	Primary ICD Diagnosis Code Description	Total Hospitalizations without Cefdinir	Readmission Without Cefdinir	Readmission Rate without Cefdinir	Total Hospitalizations with Cefdinir	Readmission with Cefdinir	Readmission Rate with Cefdinir	Readmission Odds Ratio	Reduction in Readmission with Cefdinir (%)	Confidence Interval (-)	Confidence Intervals (+)
J189	Pneumonia, unspecified organism	1609

Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Pneumonia at major Hospitals were not prescribed Cefdinir within 7 days of discharge.

ICD CODE	Hospital	Hospitalizations with Pneumonia	% of Hospitalizations without Cefdinir
J189	Florida Hospital Orlando	348	98.77%
	Christiana Hospital	1543	98.19%
	UMass Memorial Medical Center	543	97.61%

Hospitalizations with Pneumonia = Above Listed ICD Codes

If figures are shared with “At Least” - this implies that the drug utilization within 7 days post hospitalization is less than 11

Conclusions:

According to analysis of Real-World Evidence of Medicare Claims data, for hospitalizations between January 2017 to September 2019, the use of Cefdinir within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Pneumonia patients at Florida Hospital Orlando. This analysis shows that a significant number of Patients are not dispensed Cefdinir after Pneumonia hospitalizations at Florida Hospital Orlando or at major US Hospitals.

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