PMU66 EXAMINING THE RELATIONSHIP BETWEEN PATIENT SATISFACTION AND ANTIBIOTIC PRESCRIBING FOR ACUTE ADULT BRONCHITIS IN AN AMBULATORY SETTING

Abstract

Despite evidence that antibiotic prescriptions should be avoided in patients diagnosed with acute adult bronchitis (AAB), care providers (CP) often over-prescribe, citing concern that not giving an antibiotic will result in low patient satisfaction (PS) ratings. The objective of this study is to examine the relationship between antibiotic prescribing and PS. International Classification of Diseases codes were used to identify AAB visits. Visit-level data were matched to PS surveys for the first visit and first survey for each patient. Descriptive statistics and logistic regression were used. The dependent variable was a PS survey item asking patients to rate their CP from 0 (worst) to 10 (best). A dichotomous variable was created using top-box scores (9&10) vs. non-top-box scores (0-8). The independent variable was prescription of antibiotic (yes/no). Covariates included 9 survey items rating the care provider, support staff, and clinic, and patient demographics (age, gender, race, insurance type). were considered significant at p-value <0.05. The final dataset included 2,372 eligible visits: 83% (n=1,960) resulted in an antibiotic prescription and 17% (n=412) did not. The mean age was 60 years old, 61% were female, and 85% were white. The majority (61%) had commercial insurance and 37% had Medicare insurance. The overall model reached significance but the primary predictor (antibiotic yes/no) did not. Significant covariates were: concern CP showed (adjusted odds ratio (AOR)=0.433, 95% Confidence Interval (95% CI)=0.221-0.849, p=0.0148); time with CP (AOR=0.558, 95% CI=0.356-0.873, p=0.0107); explanations from CP (AOR=0.419, 95% CI=0.273-0.642, p<0.0001); overall clinic wait time (AOR=0.555, 95% CI=0.451-0.684, p<0.0001); gender (AOR=1.441, 95% CI=1.003-2.068, p=0.0479). This study found no significant relationship between receipt of an antibiotic prescription and PS. These results suggest that rather than prescribing antibiotics, care providers can better impact patient satisfaction through attitude (showing concern), time (with patient), and explanations (about diagnosis).