Examining Nursing Home Information Technology Maturity and Antibiotic Use Among Long-Term Care Residents

Area of Science:

• Gerontology
• Health Informatics
• Infectious Disease Epidemiology

Background:

• Antibiotic use in US nursing homes (NHs) affects up to 15% of residents daily, often inappropriately, raising concerns about quality, safety, and antibiotic resistance.
• Information technology (IT) maturity, defined by integrated technological devices and software across care, clinical support, and administration, may enhance tracking and reporting of antibiotic use in NHs.

Purpose of the Study:

• To explore trends in IT maturity over time in US nursing homes.
• To investigate the association between IT maturity and antibiotic use among long-stay NH residents.

Main Methods:

• A repeated cross-sectional study analyzed data from 817 Medicare-certified US NHs between 2013 and 2017.
• Data included annual IT maturity surveys, Minimum Data Set (MDS) 3.0 resident assessments, and facility characteristic data.
• Descriptive statistics and multivariate regressions controlling for resident and NH characteristics were employed.

Main Results:

• The study included 219,461 MDS assessments from 80,237 long-stay residents (aged ≥65 years).
• IT maturity significantly increased across the four-year study period.
• Positive association found between IT integration in administrative processes and antibiotic use (AOR 1.072, 95% CI 1.025, 1.122).

Conclusions:

• IT components integrating administrative activities correlate with changes in antibiotic use patterns in NHs.
• Further research is necessary to determine if higher IT maturity leads to more appropriate antibiotic use.
• Findings suggest policymakers should consider promoting IT with capabilities that support antibiotic stewardship programs.