Healthcare Claims Data: An Underutilized Tool for Pediatric Outpatient Antimicrobial Stewardship.

摘要: Background. Healthcare claims are underutilized to identify factors associated with high outpatient antibiotic use. Methods. We evaluated ambulatory encounter of Medicaid-insured children in 34 Ohio counties 2014. Rates total and azithromycin prescriptions dispensed were determined by county patient residence. Standardized treatment rates estimated for uncomplicated upper respiratory tract encounters (acute otitis media, pharyngitis, sinusitis, presumed viral infection) after adjusting age provider type. Uncomplicated included healthy at initial presentation illness. Adjusted odds calculated age, type, characteristics (rural vs metropolitan; poverty rate). Results. Retail pharmacies 255291 antibiotics this cohort More than 25% <3 years. County 530.4-1548.3 57.3-378.7 per 1000 person-years, respectively. Of 246866 encounters, (within 3 days) 46.1%. Presumed infection accounted 18.5% antibiotics. ranged widely from 35.9% (95% confidence interval [CI], 33.3%-38.5%) 63.2% CI, 61.5%-64.9%). Compared pediatricians, adjusted ratio was 2.02 1.96-2.07) family physicians 1.74 1.68-1.79) nurse practitioners. Residence rural or high-poverty increased treatment. Conclusions. useful populations providers Claims data could be considered track report prescribing frequency, especially where electronic medical records not available.