Inappropriate Antibiotic Prescribing for Respiratory Conditions Does Not Improve Press Ganey Patient Satisfaction Scores in the Emergency Department

Abstract

Background The literature has mixed results regarding the relationship between antibiotic prescribing and patient satisfaction in the emergency department (ED) for antibiotic-inappropriate respiratory diagnoses. The objective of the study was to determine if ED patients who receive nonindicated antibiotic prescriptions for respiratory tract conditions have increased Press Ganey patient satisfaction scores compared with those who do not receive antibiotics. Methods This was a retrospective observational study. Using an administrative electronic health record data set from 2 EDs in the Midwest, we identified 619 ED encounters resulting in discharge for antibiotic-inappropriate respiratory diagnoses with a corresponding Press Ganey patient satisfaction survey. We compared sociodemographics, encounter variables, and overall Press Ganey patient satisfaction scores between those who did and did not receive antibiotics. We analyzed Press Ganey scores by categorical score distribution and as a dichotomized scale of top box (5) vs other scores. A logistic regression estimated the odds of a top box Press Ganey patient satisfaction score based on antibiotic prescribing while controlling for other covariates. Results In the final sample, 158 (26%) encounters involving antibiotic-inappropriate respiratory diagnoses involved an antibiotic prescription. There were no differences in sociodemographic, encounter or categorical, or top box Press Ganey overall patient satisfaction scores between the groups that did and did not receive inappropriate antibiotics. In the fully adjusted regression model, antibiotic prescriptions were not associated with increased odds of top box Press Ganey patient satisfaction score (odds ratio, 0.78; 95% CI, 0.53–1.14). Conclusions Our findings suggest that nonindicated antibiotic prescribing for respiratory tract conditions is not a primary driver of overall Press Ganey scores in the ED.

Less is more: Recommendations for achieving best practices in antibiotic use for acute upper respiratory infections

“…Unaffiliated, vendor‐supplied emergency physicians were more likely to prescribe an antibiotic than those who were system employed 8 . Although overprescription is sometimes blamed on the solicitation of patient satisfaction, antibiotic prescriptions have not been found to be associated with increased odds of top box Press Ganey scores 9 …”

“… 8 Although overprescription is sometimes blamed on the solicitation of patient satisfaction, antibiotic prescriptions have not been found to be associated with increased odds of top box Press Ganey scores. 9 …”

“…8 Although overprescription is sometimes blamed on the solicitation of patient satisfaction, antibiotic prescriptions have not been found to be associated with increased odds of top box Press Ganey scores. 9 The physical health care settings most prone to inappropriate use are uncertain, with conflicting reports that gesture between the ED or UCC and other office-based settings. [10][11][12] Although reports demonstrate decreased or stagnated antibiotic use in the ED, [13][14][15] and there is a paucity of literature regarding UCC trends.…”