The Volume-Quality Relationship in Antibiotic Prescribing
For many surgeries and high-risk medical conditions, higher volume providers provide higher quality care. The impact of volume on more common medical conditions such as acute respiratory infections (ARIs) has not been examined. Using electronic health record data...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2015-02-01
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| Series: | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| Online Access: | http://inq.sagepub.com/content/52/0046958015571130.full.pdf |
| _version_ | 1818516740416471040 |
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| author | Courtney A. Gidengil MD MPH Jeffrey A. Linder MD, MPH Gerald Hunter MS Claude Setodji PhD Ateev Mehrotra MD, MPH |
| author_facet | Courtney A. Gidengil MD MPH Jeffrey A. Linder MD, MPH Gerald Hunter MS Claude Setodji PhD Ateev Mehrotra MD, MPH |
| author_sort | Courtney A. Gidengil MD MPH |
| collection | DOAJ |
| description | For many surgeries and high-risk medical conditions, higher volume
providers provide higher quality care. The impact of volume on more common medical
conditions such as acute respiratory infections (ARIs) has not been examined. Using
electronic health record data for adult ambulatory ARI visits, we divided primary care
physicians into ARI volume quintiles. We fitted a linear regression model of antibiotic
prescribing rates across quintiles to assess for a significant difference in trend.
Higher ARI volume physicians had lower quality across a number of domains, including
higher antibiotic prescribing rates, higher broad-spectrum antibiotic prescribing, and
lower guideline concordance. Physicians with a higher volume of cases manage ARI very
differently and are more likely to prescribe antibiotics. When they prescribe an
antibiotic for a diagnosis for which an antibiotic may be indicated, they are less
likely to prescribe guideline-concordant antibiotics. Given that high-volume physicians
account for the bulk of ARI visits, efforts targeting this group are likely to yield
important population effects in improving quality. |
| first_indexed | 2024-12-11T00:46:15Z |
| format | Article |
| id | doaj.art-f809ef93611e4879914507c717335a08 |
| institution | Directory Open Access Journal |
| issn | 0046-9580 1945-7243 |
| language | English |
| last_indexed | 2024-12-11T00:46:15Z |
| publishDate | 2015-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| spelling | doaj.art-f809ef93611e4879914507c717335a082022-12-22T01:26:47ZengSAGE PublishingInquiry: The Journal of Health Care Organization, Provision, and Financing0046-95801945-72432015-02-015210.1177/004695801557113010.1177_0046958015571130The Volume-Quality Relationship in Antibiotic PrescribingCourtney A. Gidengil MD MPHJeffrey A. Linder MD, MPHGerald Hunter MSClaude Setodji PhDAteev Mehrotra MD, MPHFor many surgeries and high-risk medical conditions, higher volume providers provide higher quality care. The impact of volume on more common medical conditions such as acute respiratory infections (ARIs) has not been examined. Using electronic health record data for adult ambulatory ARI visits, we divided primary care physicians into ARI volume quintiles. We fitted a linear regression model of antibiotic prescribing rates across quintiles to assess for a significant difference in trend. Higher ARI volume physicians had lower quality across a number of domains, including higher antibiotic prescribing rates, higher broad-spectrum antibiotic prescribing, and lower guideline concordance. Physicians with a higher volume of cases manage ARI very differently and are more likely to prescribe antibiotics. When they prescribe an antibiotic for a diagnosis for which an antibiotic may be indicated, they are less likely to prescribe guideline-concordant antibiotics. Given that high-volume physicians account for the bulk of ARI visits, efforts targeting this group are likely to yield important population effects in improving quality.http://inq.sagepub.com/content/52/0046958015571130.full.pdf |
| spellingShingle | Courtney A. Gidengil MD MPH Jeffrey A. Linder MD, MPH Gerald Hunter MS Claude Setodji PhD Ateev Mehrotra MD, MPH The Volume-Quality Relationship in Antibiotic Prescribing Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| title | The Volume-Quality Relationship in Antibiotic Prescribing |
| title_full | The Volume-Quality Relationship in Antibiotic Prescribing |
| title_fullStr | The Volume-Quality Relationship in Antibiotic Prescribing |
| title_full_unstemmed | The Volume-Quality Relationship in Antibiotic Prescribing |
| title_short | The Volume-Quality Relationship in Antibiotic Prescribing |
| title_sort | volume quality relationship in antibiotic prescribing |
| url | http://inq.sagepub.com/content/52/0046958015571130.full.pdf |
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