Inappropriate outpatient antibiotic use in children insured by Kentucky Medicaid
| العنوان: | Inappropriate outpatient antibiotic use in children insured by Kentucky Medicaid |
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| المؤلفون: | Navjyot Vidwan, Kahir Jawad, Michelle D. Stevenson, Bethany A. Wattles, Yana Feygin, Maiying Kong, Michael J. Smith |
| المصدر: | Infection control and hospital epidemiology. 43(5) |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Microbiology (medical), Chronic condition, medicine.medical_specialty, Epidemiology, Population, MEDLINE, Kentucky, Pharmacy, Inappropriate Prescribing, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Outpatients, Medicine, Humans, 030212 general & internal medicine, Medical prescription, Practice Patterns, Physicians', education, Child, Retrospective Studies, education.field_of_study, business.industry, Medicaid, Infant, Newborn, Infant, Odds ratio, Confidence interval, United States, Anti-Bacterial Agents, Infectious Diseases, Cross-Sectional Studies, Family medicine, Child, Preschool, business |
| الوصف: | Objective:To describe risk factors associated with inappropriate antibiotic prescribing to children.Design:Cross-sectional, retrospective analysis of antibiotic prescribing to children, using Kentucky Medicaid medical and pharmacy claims data, 2017.Participants:Population-based sample of pediatric Medicaid patients and providers.Methods:Antibiotic prescriptions were identified from pharmacy claims and used to describe patient and provider characteristics. Associated medical claims were identified and linked to assign diagnoses. An existing classification scheme was applied to determine appropriateness of antibiotic prescriptions.Results:Overall, 10,787 providers wrote 779,813 antibiotic prescriptions for 328,515 children insured by Kentucky Medicaid in 2017. Moreover, 154,546 (19.8%) of these antibiotic prescriptions were appropriate, 358,026 (45.9%) were potentially appropriate, 163,654 (21.0%) were inappropriate, and 103,587 (13.3%) were not associated with a diagnosis. Half of all providers wrote 12 prescriptions or less to Medicaid children. The following child characteristics were associated with inappropriate antibiotic prescribing: residence in a rural area (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.07–1.1), having a visit with an inappropriate prescriber (OR, 4.15; 95% CI, 4.1–4.2), age 0–2 years (OR, 1.39; 95% CI, 1.37–1.41), and presence of a chronic condition (OR, 1.31; 95% CI, 1.28–1.33).Conclusions:Inappropriate antibiotic prescribing to Kentucky Medicaid children is common. Provider and patient characteristics associated with inappropriate prescribing differ from those associated with higher volume. Claims data are useful to describe inappropriate use and could be a valuable metric for provider feedback reports. Policies are needed to support analysis and dissemination of antibiotic prescribing reports and should include all provider types and geographic areas. |
| تدمد: | 1559-6834 0899-823X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9515df1b59f9f6833600d725c20c6c47 https://pubmed.ncbi.nlm.nih.gov/33975663 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....9515df1b59f9f6833600d725c20c6c47 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15596834 0899823X |
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