The Volume-Quality Relationship in Antibiotic Prescribing
When More Isn’t Better
Bibliographic Data
| ID | 13775715 |
|---|---|
| Authors | Courtney A Gidengil (0000-0002-3561-8199, RAND Corporation, Boston, MA, USA, corresponding author), Jeffrey A Linder (0000-0003-2217-184X, Division of General Medicine and Primary Care, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA), Gerald Hunter (RAND Corporation, Pittsburgh, PA, USA), Claude Messan Setodji (0000-0001-9592-422X, RAND Corporation), Claude Setodji (RAND Corporation, Pittsburgh, PA, USA), Ateev Mehrotra (0000-0003-2223-1582, Harvard Medical School) |
| Year | 2015 |
| Volume | 52 |
| Publication date | 2015-01-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | INQUIRY The Journal of Health Care Organization Provision and Financing (JOURNAL) |
| Journal identifiers | ISSN: 0046-9580 • E-ISSN: 1945-7243 |
| Publisher | SAGE Publishing (PUBLISHER • US) |
| DOI | 10.1177/0046958015571130 |
| PMID | 25672338 |
| PMCID | PMC4327773 |
| OpenAlex | W2155034607 |
| Language | EN |
| Citations received | 1 |
| References cited | 8 |
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
Ambulatory · Ambulatory care · Antibiotics · Concordance · Environmental health · Guideline · Health care · Intensive care medicine · Medical record · Population · Antibiotic Use and Resistance · Emergency Medicine · Internal Medicine · Medicine · Patient Satisfaction in Healthcare · Pneumonia and Respiratory Infections
| Citations per year | 0.1 |
|---|---|
| Citation span | 2016 - 2016 (1) |
| Highly cited | No |