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Unnecessary testing led to increased cost, antibiotic overuse
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SAN FRANCISCO — Increased patient charges and antibiotic overuse is caused by unnecessary testing, according to study findings presented here at ID Week 2013.
“Group A beta-hemolytic streptococcus (GAS) is the most common cause of bacterial pharyngitis, accounting for 15%-30% of pharyngitis in children,” the researchers wrote. “Streptococcal pharyngitis is generally overdiagnosed, leading to excess patient charges and unnecessary antibiotic use.”
Researchers examined medical records of children with a rapid streptococcal antigen detection test (RADT) from February to April 2012. Overall, 359 children were included in the study.
Sixty-four percent of RADTs were unnecessary, the most common reasons being viral symptoms (55%) and no sore throat (26%). This resulted in more than $33,000 in excess patient charges. Overall, unnecessary treatment was given to 44% of participants due to the presence of viral (53%) or two or fewer GAS symptoms (39%).
Testing practices were similar among physicians/nurse practitioners (52%) and nurses (48%). Unnecessary RADTs were given for similar reasons among physicians/nurse practitioners and nurses, including viral symptoms (43% and 50%, respectively), and two or fewer GAS symptoms (30% and 33%, respectively).
“The majority of GAS testing in our ED is unnecessary; and is equal across practitioner type,” the researchers wrote. “Unnecessary testing leads to increased patient charges and antibiotic overuse. Future quality improvement interventions will include GAS testing criteria education targeting all practitioners.”
For more information:
Bradley K. Abstract #872. Presented at: ID Week 2013; Oct. 2-6, 2013; San Francisco.
Disclosure: The researchers report no relevant financial disclosures.