To validate the use of administrative data to identify patients with bacterial meningitis and benchmark the rate of dexamethasone administration in this population.

Studies have demonstrated the benefit of adjuvant dexamethasone for adults with acute bacterial meningitis. This has been reflected in the Inpatient and Emergency Care Quality Measurement Set published by the Â鶹´«Ã½Ó³»­. To our knowledge, achievable benchmarks of care have not been determined for this practice.

The Vizient Clinical Data Base was used to identify non-pediatric inpatient encounters from a large academic hospital from January 2015 to July 2019 with ICD-10 codes for bacterial meningitis. Chart review of the hospital electronic health record was performed to confirm the diagnosis of bacterial meningitis, evaluate for any exceptions listed in the quality measurement set, and identify treatment strategies.

81 patients were identified via Vizient. 71 patients had a diagnosis of bacterial meningitis based on chart review (PPV = 88%). Of the patients with confirmed bacterial meningitis, 13 patients did not have any exceptions to receiving dexamethasone per the measurement set. 2 of the 13 patients were admitted to a Neurology service and 8 had a Neurology consultation during their hospital course. 5 patients (38%) received dexamethasone.  

Our analysis confirms that it is feasible to use administrative data to identify patients with bacterial meningitis. Our findings highlight that neurologists do not frequently encounter patients with bacterial meningitis who would benefit from dexamethasone administration per the quality measurement set. As healthcare systems move to pay-for-performance models, quality measurement sets that are clinically relevant and feasible to collect data on will be vital. This study demonstrates that administrative data can be used to determine the burden of neurologic disease and treating physician specialties to help guide the development of future quality measurement sets.