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Provider and patient drivers of ototopical antibiotic prescription variability.
- Source :
-
American journal of otolaryngology [Am J Otolaryngol] 2015 Nov-Dec; Vol. 36 (6), pp. 814-9. Date of Electronic Publication: 2015 Jul 07. - Publication Year :
- 2015
-
Abstract
- Objective: To determine if providers prescribe more affordable topical antibacterial therapy for patients who are economically disadvantaged or come from economically disadvantaged communities.<br />Study Design: Prescription drug database review.<br />Setting: Large academic hospital network.<br />Subjects and Methods: Ototopical prescription records of 2416 adults and children presenting with acute and chronic otologic infections from 2009 to 2013 were reviewed. Prescription, patient, provider, and institution variables including diagnosis, prescription type, demographics, health insurance status, healthcare provider type and setting were analyzed.<br />Results: Otitis externa and acute otitis media were the most common diagnoses. Non-OHNS (Otolaryngology-Head and Neck Surgery) providers served 82% of all patients. OHNS providers prescribed proportionally less fluoroquinolone, and more brand-name antibiotics compared to non-OHNS providers. Adults were more likely to receive a non-fluoroquinolone antibiotic and a generic prescription versus pediatric patients. Patients who self-identified as 'white' ethnicity received proportionally more fluoroquinolone prescriptions than patients who identified as 'non-white,' but there was no difference in provider type. The proportion of fluoroquinolone prescriptions was significantly higher in patients from low-poverty counties, however poverty level was not associated with patients seeing a particular provider type. The majority of our patients had commercial insurance, followed by Medicaid. Medicare patients had the lowest proportion of fluoroquinolone antibiotic prescriptions, and were less likely to receive fluoroquinolone prescriptions versus commercial insurance. Non-insured patients received proportionally more generic versus brand prescriptions than insured patients.<br />Conclusion: Our results indicate potential provider, patient demographic, and financial factors producing considerable variability in the prescribing patterns for topical antibiotics for common otologic infections.<br /> (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Subjects :
- Academic Medical Centers
Administration, Topical
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Databases, Factual
Drugs, Generic
Female
Fluoroquinolones
Humans
Infant
Infant, Newborn
Male
Medically Uninsured statistics & numerical data
Medicare statistics & numerical data
Middle Aged
North Carolina epidemiology
Otitis Externa drug therapy
Otitis Externa epidemiology
Otitis Media drug therapy
Otitis Media epidemiology
Poverty Areas
Racial Groups statistics & numerical data
Rural Population statistics & numerical data
Tympanic Membrane Perforation drug therapy
Tympanic Membrane Perforation epidemiology
United States epidemiology
Urban Population statistics & numerical data
Young Adult
Anti-Bacterial Agents
Drug Prescriptions statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1532-818X
- Volume :
- 36
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- American journal of otolaryngology
- Publication Type :
- Academic Journal
- Accession number :
- 26545478
- Full Text :
- https://doi.org/10.1016/j.amjoto.2015.07.001