Volpi Connor, Shehadeh Fadi, Mylonakis Eleftherios
Brown University School of Public Health, 121 South Main Street.
Division of Infectious Diseases, Warren Alpert Medical School of Brown University, Providence, RI 02903.
Medicine (Baltimore). 2019 May;98(22):e15914. doi: 10.1097/MD.0000000000015914.
The objective of this study was to examine whether patient income has an impact on likelihood of being prescribed an antimicrobial agent at the county level. A better understanding of factors that influence antimicrobial prescription is needed to efficiently mitigate rates of antimicrobial agents prescribed.This cross-sectional study used data from two publicly available datasets. The 2015 Medicare Part D PUF data quantifies the antimicrobial prescription rate at the county level and data from US Census Bureau provides information on socioeconomic status at the county level.At the county level, we explained 48% of the variation in antimicrobial prescriptions by socioeconomic status, age, gender, and race. More specifically, socioeconomic status accounted for 26% of the variation in antimicrobial rate and as income increased, correlation with antimicrobial prescription rate trended down.We determined patient income and other sociodemographics to influence the prescription of antimicrobial agents. Interventions should consider these factors to effectively evaluate antimicrobial prescription methods. Findings from this study can help guide intervention efforts which aim to minimize the number of inappropriate antimicrobials prescribed, such as antimicrobial stewardship programs. Effective interventions have the capability of decreasing levels of inappropriate antimicrobials prescribed and prevent future cases of resistance.
本研究的目的是检验患者收入在县级层面是否会对开具抗菌药物处方的可能性产生影响。为了有效降低抗菌药物的处方率,需要更好地了解影响抗菌药物处方的因素。这项横断面研究使用了两个公开数据集的数据。2015年医疗保险D部分的药房使用文件(PUF)数据量化了县级层面的抗菌药物处方率,而美国人口普查局的数据提供了县级层面的社会经济状况信息。在县级层面,我们发现社会经济状况、年龄、性别和种族能够解释48%的抗菌药物处方差异。更具体地说,社会经济状况占抗菌药物使用率差异的26%,并且随着收入增加,与抗菌药物处方率的相关性呈下降趋势。我们确定患者收入和其他社会人口统计学因素会影响抗菌药物的处方。干预措施应考虑这些因素,以有效评估抗菌药物的处方方法。本研究的结果有助于指导旨在尽量减少不适当抗菌药物处方数量的干预工作,如抗菌药物管理计划。有效的干预措施有能力降低不适当抗菌药物的处方水平,并预防未来的耐药病例。