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

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. This study compared pediatric intensive care units (PICU) blood culture use derived from administrative data with hospital reported data and found differences that warrant consideration before administrative data are used for monitoring blood culture use in diagnostic stewardship programs in PICUs.

Automated summary

This study aimed to determine whether administrative data could be used as a data source to measure blood culture use in pediatric intensive care units (PICUs). The study found differences between administrative data and hospital-reported data, suggesting that the limitations of administrative data should be carefully considered when monitoring blood culture use.