Regional variation in antibiotic prescribing among medicare part D enrollees, 2013.
Regional variation in antibiotic prescribing among medicare part D enrollees, 2013.
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DOI：
10.1186/s12879-016-2091-0
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发表时间：
2016-12-09
影响因子：
3.7
通讯作者：
Aitken SL
中科院分区：
文献类型：
--
作者：
Arizpe A;Reveles KR;Aitken SL
抗生素是最广泛使用的药物之一。医疗保险 D 部分接受者之间抗生素处方模式和相关费用的地理差异尚未得到描述。本研究的目的是评估 2013 年 Medicare D 部分参保者抗生素处方和费用的地区差异。使用 Medicare 提供者利用和支付数据：D 部分处方者公共使用文件，对 2013 年所有 Medicare D 部分参保者进行回顾性队列审查。 D 部分处方者公共使用文件中列出的所有抗生素原始或补充处方索赔均包含在内。我们的主要结果是抗生素索赔总额和每位 Medicare D 部分参与者的抗生素费用。数据按美国人口普查局定义的州和地理区域进行描述性分析。抗生素声明按抗生素类别进行了整体描述。 2013 年，D 部分参与者提交了超过 5,400 万份门诊抗生素索赔，相当于抗生素总支出超过 15 亿美元。南部地区抗生素使用率最高（1,623 项索赔/1,000 名登记者），其次是中西部（1,401 项索赔/1,000 名登记者）、东北部（1,366 项索赔/1,000 名登记者）和西部（1,292 项索赔/1,000 名登记者）。每个地区每位参与者的平均抗生素费用如下：南部 46.58 美元，东北部 43.70 美元，中西部 40.54 美元，西部 36.42 美元。氟喹诺酮类药物是最常开处方的类别（1220 万次申请）。美国老年医疗保险参保者的抗生素使用率在南部地区最高。氟喹诺酮类药物是所有地区最常用的抗生素。这些模式可用于制定有针对性的抗菌药物管理工作。本文的在线版本 (doi:10.1186/s12879-016-2091-0) 包含补充材料，可供授权用户使用。
Antibiotics are among the most widely prescribed medications. The geographic variation in antibiotic prescribing patterns and associated costs among Medicare Part D recipients have not been described. The purpose of this study was to assess the regional variation in antibiotic prescriptions and costs among Medicare Part D enrollees in 2013. Retrospective cohort review of all Medicare Part D enrollees in 2013, using the Medicare Provider Utilization and Payment Data: Part D Prescriber Public Use File. All original or refill prescription claims for antibiotics as listed in the Part D Prescriber Public Use File were included. Our primary outcomes were total antibiotic claims and antibiotic cost per Medicare Part D Enrollee. Data were analyzed descriptively by state and by geographic region as defined by the United States Census Bureau. Antibiotic claims were described overall and by antibiotic class. Over 54 million outpatient antibiotic claims were filed for Part D enrollees in 2013, representing more than $1.5 billion in total antibiotic expenditures. Antibiotic use was highest in the South (1,623 claims/1,000 enrollees), followed by the Midwest (1,401 claims/1,000 enrollees), Northeast (1,366 claims/1,000 enrollees), and West (1,292 claims/1,000 enrollees). Average antibiotic costs per enrollee in each region were as follows: South $46.58, Northeast $43.70, Midwest $40.54, and West $36.42. Fluoroquinolones were the most commonly prescribed class overall (12.2 million claims). Antibiotic use among elderly Medicare enrollees in the United States was highest in the South region. Fluoroquinolones were the most common antibiotics used in all regions. These patterns could be utilized in the development of targeted antimicrobial stewardship efforts. The online version of this article (doi:10.1186/s12879-016-2091-0) contains supplementary material, which is available to authorized users.
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