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Volume 20, Number 5—May 2014

Dispatch

Factors Associated with Antimicrobial Drug Use in Medicaid Programs

Pengxiang LiComments to Author , Joshua P. Metlay, Steven C. Marcus, and Jalpa A. Doshi
Author affiliations: University of Pennsylvania, Philadelphia, Pennsylvania, USA

Main Article

Table 1

Characteristics of 194,874 adult Medicaid patients with acute respiratory tract infection, 40 US states, January 1–December 24, 2007*

Variable No. (%) or mean (SD)
Age, y, no. (%)
21–29 45,447 (23.3)
30–39 42,977 (22.1)
  40–49 42,924 (22)
  50–59 38,376 (19.7)
  60–64 16,929 (8.7)
  >65
8,221 (4.2)
Sex, no. ( %)
  F 143,329 (73.5)
  M
51,545 (26.5)
Race, no. ( %)
  White 100,310 (51.5)
  Black 46,282 (23.7)
  Hispanic 16,404 (8.4)
  Other
31,878 (16.4)
Diagnosis at index visit, no. (%)
  Cold or acute URIs (ICD-9 codes 460 and 465) 113,394 (58.2)
  Acute bronchitis (ICD-9 code 466)
81,480 (41.8)
RxHCC score, mean (SD)†
0.5 (0.6)
Quarter of index visit date, no. (%)
  Jan–Mar 85,601 (43.9)
  Apr–Jun 36,771 (18.9)
  Jul–Sep 30,807 (15.8)
  Oct–Dec
41,695 (21.4)
Residence in low-education county, no. (%)‡
  No 144,335 (74.1)
  Yes
50,539 (25.9)
County-level annual per capita income, mean (SD)
32,700 (15.6)
Residence in urban area, no. (%)
  No 65,766 (33.7)
  Yes
129,108 (66.3)
Residence in state participating in CDC Get Smart campaign, no. (%)§
  No 38,332 (19.7)
  Yes
156,542 (80.3)
Primary care physicians/10,000 persons in county, no. (%)¶
  <2.2 14,816 (7.6)
  2.2–3.4 28,500 (14.6)
  3.5–4.7 34,017 (17.5)
  4.8–6.5 47,460 (24.4)
  >6.5 70,081 (36)

*Data from the 2007 Medicaid Analytic Extract files linked with the Area Resource File. URI, upper respiratory tract infection; ICD-9, International Classification of Diseases, Ninth Revision; RxHCC, prescription drug Hierarchical Coexisting Condition; CDC, Centers for Disease Control and Prevention.
†Modified RxHCC score used here, wherein coefficients for age and sex are zeroed out in the score calculation because regression models separately control for these variables. Range in sample described here 0–5.3. A higher score indicates a higher medical comorbidity burden.
‡County with >25% adults without a high school diploma.
§In this sample, 33 of 40 states participated in the CDC Get Smart campaign during 2002–2006.
¶Categories were based on quintile of county-level number of primary care physicians/10,000 persons. Each category includes 644 counties.

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