Al Mohajer Mayar, Slusky David, Nix David, Nicodemo Catia
Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Department of Continuous Education, University of Oxford, Oxford, UK.
JAC Antimicrob Resist. 2024 Nov 23;6(6):dlae191. doi: 10.1093/jacamr/dlae191. eCollection 2024 Dec.
Our study aimed to assess whether there was a relationship between graduating from higher-ranked medical schools and the rate of prescribing antibiotics among Medicare Part D providers in the USA.
The study obtained data from the Medicare Part D Prescribers (FY2013-2021) and the Doctor and Clinicians National repositories. A regression model was fitted to assess the relationship between provider medical school ranking and the rate of antibiotic days supplied per 100 beneficiaries at the provider level.
A total of 197 540 providers were included. No association was found between the medical school ranking and the rate of antibiotics days supplied per 100 beneficiaries. Instead, the type of provider is associated with the prescription rates. Hospitalists and Emergency Medicine providers had fewer days supplied per 100 beneficiaries than Family Medicine providers. In contrast, students, more experienced providers (>20 years since medical school graduation) and females had more days supplied per 100 beneficiaries.
Our study highlights the need for robust outpatient stewardship interventions and incorporating an outcome-based approach to antibiotic stewardship curricula in medical and mid-level provider schools.
我们的研究旨在评估在美国医疗保险D部分提供者中，毕业于排名较高的医学院与抗生素处方率之间是否存在关联。
该研究从医疗保险D部分处方者（2013财年至2021年）以及医生和临床医生国家数据库中获取数据。拟合了一个回归模型，以评估提供者医学院排名与每100名受益人的抗生素供应天数率之间的关系。
共纳入197540名提供者。未发现医学院排名与每100名受益人的抗生素供应天数率之间存在关联。相反，提供者类型与处方率相关。住院医师和急诊医学提供者每100名受益人的供应天数少于家庭医学提供者。相比之下，学生、经验更丰富的提供者（自医学院毕业超过20年）和女性每100名受益人的供应天数更多。
我们的研究强调了在门诊进行有力的管理干预以及在医学和中级提供者学校的抗生素管理课程中纳入基于结果的方法的必要性。
