using medicaid data to map avoidable prescribing practicesfebruary 10, 2019 using medicaid data to...

February 10, 2019

Using Medicaid Data to MapAvoidable Prescribing Practices

Emily Lutterloh, MD, MPHDirector, Bureau of Healthcare Associated InfectionsNew York State Department of Health

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https://www.cdc.gov/antibiotic-use/community/images/programs-measurement/Community-antibiotic-map-2015.jpg

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Analysis• Collaboration with NYSDOH Office of Quality and

Patient Safety– Access to and experience with Medicaid data

• Identify initial visits to outpatient providers for acute upper respiratory infections (URIs)

• Use pharmacy claims data to identify visits when an antibiotic was prescribed and subsequently filled

• Determine regional rates of prescribing for URIs to better target interventions

Based on: Li P, Metlay JP, Marcus SC, Doshi JA. Factors associated with antimicrobial drug usein Medicaid programs. Emerg Infect Dis (Internet). 2014; 20(5): 829-832. https://dx.doi.org/10.3201/eid2005.130493

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Analysis• Mapped potentially

avoidable prescribingfor URIs

• Created county-levelmaps based onprovider practicelocation

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Adult Outpatient Antibiotics for Acute URI, 2010 - 2016

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Pediatric Outpatient Antibiotics for Acute URI, 2010 - 2016

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Outreach: Letter to Prescribers• Sent “Dear

Provider” letters and map to providers in 11 high-prescribing counties likely to see patients for URIs

• Followed up with educational materials

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InterventionsAntibiotic Resistance Task Force

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The Future• Next Steps

– Additional years– Other conditions,

e.g. pharyngitis, otitis media

– Overall antibiotic prescribing per Medicaid enrollee

– Assess adherence to guidelines

– Other insurers

• Impact– Target other initiatives– Multiple other initiatives

ongoing simultaneously• Difficult to measure

– Continue to follow as additional yearsof data become available

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Thank You

https://www.cdc.gov/antibiotic-use/community/materials-references/print-materials/hcp/index.html