Antibiotics for Upper Respiratory Tract Infections in Ambulatory Practice in the United States, 1997–1999: Does Physician Specialty Matter?

Olivier T. Rutschmann; Marisa Elena Domino

doi:10.3122/jabfm.17.3.196

Article Figures & Data

Tables

View popup

Table 1.

Possible Predictors of Ambulatory Antibiotic Prescription for Upper Respiratory Infections in the United States, 1997 to 1999

Predictors	Office Visit Sample for a URI [% (n)]	Adjusted Odds Ratios^* (95% CI) for Antibiotic Prescription
Age
18–44	47% (449)	Referent
45–64	30% (287)	0.96 (0.68 to 1.36)
≥65	23% (220)	0.80 (0.46 to 1.40)
Female vs male	62% (593)	1.03 (0.73 to 1.44)
Nonwhite race vs white	13% (124)	0.83 (0.50 to 1.36)
Hispanic ethnicity vs not Hispanic	7% (67)	0.17 (0.08 to 0.38)
Geographic region
South	36% (343)	Referent
Midwest	26% (249)	1.43 (0.85 to 2.41)
Northeast	19% (182)	1.33 (0.76 to 2.32)
West	19% (182)	1.24 (0.72 to 2.11)
Rural area vs urban	22% (210)	1.28 (0.80 to 2.05)
Reimbursement type
Private insurance	58% (555)	Referent
Medicare	17% (163)	1.11 (0.58 to 2.12)
Medicaid	8% (76)	1.09 (0.54 to 2.20)
Selfpay	9% (86)	1.30 (0.72 to 2.36)
Other	8% (76)	1.17 (0.64 to 2.15)
HMO vs not HMO	27% (258)	0.94 (0.62 to 1.43)
Physician specialty
General/family medicine	53% (508)	Referent
General internal medicine	36% (343)	0.37 (0.18 to 0.76)
Other specialties	11% (105)	0.78 (0.33 to 1.86)
Primary care physician for this patient vs not primary care physician	81% (774)	1.70 (1.08 to 2.68)
Solo practice vs not solo practice	40% (382)	1.10 (0.76 to 1.61)
Visit duration
≤10 minutes	36% (344)	Referent
10–15 minutes	40% (382)	0.99 (0.65 to 1.50)
>15 minutes	24% (230)	1.08 (0.69 to 1.69)
X-ray during visit vs not X-ray	9% (86)	1.06 (0.64 to 1.74)
Year of survey
1997	30% (287)	Referent
1998	40% (382)	0.64 (0.36 to 1.15)
1999	30% (287)	0.50 (0.27 to 0.94)
Interaction terms:
General internal medicine ^* year 1998		2.22 (0.92 to 5.35)
General internal medicine ^* year 1999		2.02 (0.45 to 4.65)
Other specialties ^* year 1998		1.44 (0.45 to 4.65)
Other specialties ^* year 1999		1.51 (0.45 to 5.16)

* Adjusted odds ratios are reported from a logistic regression analysis using all variables reported in Table 1.

View popup
Table 2.
Predicted Rates (%) of Antibiotic Prescribing for Patients Consulting Their Primary Care Physician for URIs, by Year and Physician Specialty
Specialty 1997 1998 1999
General/Family Medicine 59.9% 49% 42.9%
General Internal Medicine 35.8% 44.3% 36.2%
Other Specialties 53.9% 52.1% 47.1%