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