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. 2023 Jul 31;12(7):436-442.
doi: 10.1093/jpids/piad048.

Comparison of Administrative Database-Derived and Hospital-Derived Data for Monitoring Blood Culture Use in the Pediatric Intensive Care Unit

Shaoming Xiao  1 , Charlotte Z Woods-Hill  2   3 , Danielle Koontz  1 , Cary Thurm  4 , Troy Richardson  4 , Aaron M Milstone  1 , Elizabeth Colantuoni  5 ; Bright STAR Authorship Group
Collaborators, Affiliations

Comparison of Administrative Database-Derived and Hospital-Derived Data for Monitoring Blood Culture Use in the Pediatric Intensive Care Unit

Shaoming Xiao et al. J Pediatric Infect Dis Soc. .

Abstract

Background: Optimizing blood culture practices requires monitoring of culture use. Collecting culture data from electronic medical records can be resource intensive. Our objective was to determine whether administrative data could serve as a data source to measure blood culture use in pediatric intensive care units (PICUs).

Methods: Using data from a national diagnostic stewardship collaborative to reduce blood culture use in PICUs, we compared the monthly number of blood cultures and patient-days collected from sites (site-derived) and the Pediatric Health Information System (PHIS, administrative-derived), an administrative data warehouse, for 11 participating sites. The collaborative's reduction in blood culture use was compared using administrative-derived and site-derived data.

Results: Across all sites and months, the median of the monthly relative blood culture rate (ratio of administrative- to site-derived data) was 0.96 (Q1: 0.77, Q3: 1.24). The administrative-derived data produced an estimate of blood culture reduction over time that was attenuated toward the null compared with site-derived data.

Conclusions: Administrative data on blood culture use from the PHIS database correlates unpredictably with hospital-derived PICU data. The limitations of administrative billing data should be carefully considered before use for ICU-specific data.

Keywords: Pediatric Health Information System; Pediatric Intensive Care Unit; administrative data; blood culture use; diagnostic stewardship.

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Figures

Figure 1.
Figure 1.
Relative blood culture rate over time comparing administrative- versus site-derived data. The dashed line is the line of equivalence indicating that the administrative-derived blood culture rate is equal to site-derived blood culture rate over time. The administrative- and site-derived blood culture rates are proportional to each other if the relative rate for a site over the study months is a horizontal line.
Figure 2.
Figure 2.
(A) Relative blood culture number over time comparing administrative- versus site-derived data. The dashed line is the line of equivalence indicating that the administrative-derived blood culture number is equal to site-derived blood culture number over time. The administrative- and site-derived blood culture numbers are proportional to each other if the relative rate for a site over the study months is a horizontal line. (B) Relative PICU patient-days over time comparing administrative- versus site-derived data. The dashed line is the line of equivalence indicating that the administrative-derived PICU patient-days are equal to site-derived PICU patient-days over number. The administrative- and site-derived PICU patient days are proportional to each other if the relative rate for a site over the study months is a horizontal line.
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