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Am J Manag Care. 2017 Oct;23(10):589-594.

Low-value antibiotic prescribing and clinical factors influencing patient satisfaction.

Author information

1
Kaiser Permanente Southern California, 100 S Los Robles Ave, Pasadena, CA 91101. E-mail: Adam.L.Sharp@kp.org.

Abstract

OBJECTIVES:

Patient-centered healthcare is a high priority and is commonly measured and incentivized through patient satisfaction surveys. There is a need to further understand if increasing satisfaction has the unintended consequence of encouraging low-value care. This study assessed the association of low-value antibiotic prescribing with patient satisfaction scores, and it evaluated patient and provider characteristics that may impact the association.

STUDY DESIGN:

Retrospective, observational study of acute sinusitis (AS) encounters for adult members of a large integrated delivery system from 2010 to 2013.

METHODS:

Bivariate and multivariate analyses evaluating the use of antibiotics, patient attributes, and provider characteristics associated with favorable patient satisfaction scores.

RESULTS:

Among 5169 encounters for AS, 79.5% of encounters in which antibiotics were prescribed had favorable satisfaction scores versus 75.4% of encounters in which they were not. Independent predictors of favorable satisfaction scores included: receipt of antibiotics (adjusted odds ratio [aOR], 1.24; 95% CI, 1.00-1.55), 45 years or older (aOR, 1.45; 95% CI, 1.24-1.69), Elixhauser Comorbidity Index score 2 or greater (aOR, 1.21; 95% CI, 1.05-1.40), provider business partner status (aOR, 1.38; 95% CI, 1.20-1.58), and a bonded encounter between a patient and their assigned primary care physician (aOR, 2.06; 95% CI, 1.75-2.44).

CONCLUSIONS:

Patient satisfaction scores are slightly lower when antibiotics are not prescribed for AS, but 75% of those encounters still received favorable satisfaction scores. Factors such as older patient age, more comorbidities, and an established patient-provider relationship had stronger associations with high patient satisfaction.

PMID:
29087630
[Indexed for MEDLINE]
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