Comparison of Antibiotic Prescribing in Retail Clinics, Urgent Care Centers, Emergency Departments, and Traditional Ambulatory Care Settings in the United States | Emergency Medicine | JAMA Internal Medicine | JAMA Network
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    1 Comment for this article
    It’s About the Money
    David S. Smith, MD | Retired Physician, Wisconsin
    As pointed out elsewhere, the business model is to make the antibiotic seeking patient happy. We, the medical field, created that patient. I was called a quack and the patient threatened to report me because I did not prescribe antibiotics for a cold that just started. He went down the road to the local urgent care center to get his prescription, and proof that I was a quack.

    It is also a lot easier to code a level 4 visit when you write a prescription. It takes time to tell somebody why they don’t need a prescription
    That is a level 3 visit most of the time.

    Research Letter
    September 2018

    Comparison of Antibiotic Prescribing in Retail Clinics, Urgent Care Centers, Emergency Departments, and Traditional Ambulatory Care Settings in the United States

    Author Affiliations
    • 1Centers for Disease Control and Prevention, Atlanta, Georgia
    • 2Pediatric Infectious Diseases, University of Utah, Salt Lake City
    • 3The Pew Charitable Trusts, Washington, DC
    JAMA Intern Med. 2018;178(9):1267-1269. doi:10.1001/jamainternmed.2018.1632

    Antibiotic use contributes to antibiotic resistance and is associated with adverse events, including Clostridium difficile infections.1 Antibiotic overuse, especially for viral respiratory infections, is common.2 Only 60% of outpatient antibiotic prescriptions dispensed in the United States are written in traditional ambulatory care settings (hereinafter “medical offices”) and emergency departments (EDs).2 Growing markets, including urgent care centers and retail clinics, may contribute to the remaining 40%.3,4 Our objective was to compare antibiotic prescribing among urgent care centers, retail clinics, EDs, and medical offices.

    We conducted a retrospective cohort study using the 2014 Truven Health MarketScan Commercial Claims and Encounters Database, which captures claims data on individuals younger than 65 years with employer-sponsored insurance.5 The National Center for Emerging and Zoonotic Infectious Diseases human subjects advisor deemed these to be deidentified data and thus exempt from ethical approval and patient written informed consent.