Background
Methods
Overview
Setting
Data sources
Data extraction
Data and statistical analysis
Results
Visit flow
Patient and illness characteristics
Characteristic | |
---|---|
Mean (SD)
| |
Age | 45 (12) |
N (%)
| |
Sex | |
Female | 710 (74) |
Male | 252 (26) |
Race and Ethnicity | |
White, non-Latino | 437 (45) |
Black, non-Latino | 278 (29) |
Latino | 160 (17) |
Asian | 53 (6) |
Unavailable/Other | 34 (4) |
Insurance Status | |
Private | 683 (71) |
Medicaid | 182 (19) |
Medicare | 81 (8) |
Self-Pay | 15 (2) |
Co-morbidities | |
Diabetes | 108 (11) |
Cancer | 51 (5) |
Rheumatologic disease | 39 (5) |
Mild liver disease | 31 (3) |
Myocardial infarction | 19 (2) |
Cerebrovascular disease | 17 (2) |
Renal disease | 15 (2) |
Characteristic | Yes | No | Not mentioned | Prescribed antibiotics |
---|---|---|---|---|
N (%) | N (%) | |||
Symptoms
| ||||
Nasal symptoms | 556 (58) | 112 (12) | 294 (31) | 132 (24) |
Sore throat | 471 (49) | 120 (12) | 371 (39) | 101 (21) |
Phlegm/sputum | 375 (39) | 316 (32) | 271 (28) | 91 (24) |
Fevers | 272 (28) | 475 (49) | 215 (22) | 76 (28) |
Headache | 223 (23) | 122 (13) | 617 (64) | 64 (29) |
Myalgias | 187 (19) | 58 (6) | 717 (75) | 46 (25) |
Shortness of breath | 134 (14) | 352 (37) | 476 (49) | 34 (25) |
Chest pain | 108 (11) | 263 (27) | 591 (61) | 19 (18) |
Physical exam findings
| ||||
Oropharyngeal abnormality | 248 (26) | 496 (52) | 218 (23) | 54 (22) |
Lymphadenopathy | 132 (14) | 613 (64) | 217 (23) | 43 (33) |
Tympanic membrane or external auditory canal abnormality | 117 (12) | 296 (31) | 549 (57) | 39 (33) |
Abnormal appearance | 114 (12) | 632 (66) | 216 (22) | 38 (33) |
Abnormal lung sounds | 106 (11) | 755 (78) | 101 (10) | 46 (43) |
Wheezing | 100 (10) | 394 (41) | 468 (49) | 27 (27) |
Diagnoses and diagnostic uncertainty
Diagnoses | Total | Residents | Non-residents | Given antibiotics | Diagnostic uncertainty |
---|---|---|---|---|---|
N (%)
| |||||
Antibiotic-appropriate
| |||||
Sinusitis | 99 (10) | 28 (7) | 71 (13) | 77 (78) | 19 (19) |
Pneumonia | 74 (8) | 32 (8) | 42 (7) | 51 (69) | 36 (49) |
Streptococcal pharyngitis | 69 (7) | 26 (7) | 43 (8) | 27 (39) | 49 (71) |
Otitis media | 16 (2) | 6 (2) | 10 (2) | 13 (81) | 1 (6) |
Bacterial infection2
| 10 (1) | 3 (1) | 7 (1) | 6 (60) | 8 (80) |
Pertussis | 9 (1) | 4 (1) | 5 (1) | 6 (67) | 6 (67) |
Subtotal
| 277 (29) | 99 (25) | 178 (32) | 180 (65) | 119 (43) |
Non-antibiotic-appropriate
| |||||
Upper respiratory infection | 445 (46) | 192 (48) | 253 (45) | 14 (3) | 12 (3) |
Acute bronchitis | 90 (9) | 34 (9) | 56 (10) | 13 (14) | 4 (4) |
Post-nasal drip | 33 (3) | 15 (4) | 18 (3) | 1 (3) | 3 (9) |
Non-streptococcal pharyngitis | 33 (3) | 18 (5) | 15 (3) | 0 (0) | 5 (15) |
Allergies | 32 (3) | 17 (4) | 15 (3) | 0 (0) | 1 (3) |
Reactive airway disease | 5 (1) | 1 (0) | 4 (1) | 0 (0) | 1 (20) |
Other3
| 47 (5) | 23 (6) | 24 (4) | 2 (4) | 6 (13) |
Subtotal
| 685 (71) | 300 (75) | 385 (68) | 29 (4) | 32 (5) |
Total
|
962 (100)
|
399 (100)
|
563 (100)
|
209 (22)
|
151 (16)
|
Number of cough-related diagnoses | Visits | Antibiotics prescribed | Diagnostic uncertainty |
---|---|---|---|
N (%)
| |||
1 diagnosis | 519 (54) | 82 (16) | 24 (5) |
2 diagnoses | 338 (35) | 84 (25) | 85 (25) |
3+ diagnoses | 105 (11) | 43 (41) | 42 (40) |
Total
|
962 (100)
|
209 (22)
|
151 (16)
|