concordance; antibiotics; overprescribing


Health Services Research | Public Health | Translational Medical Research


Objective: To examine whether patient and provider concordance by sex or race predicts antibiotic prescribing for acute bronchitis.

Study setting: General Internal Medicine and Family Medicine adult clinics at a large safety-net hospital.

Study design: We used a logistic model of prescribing as a function of race and sex concordance.

Data extraction: Data were extracted from de-identified patient records for those with an acute bronchitis visit between 2008 and 2010.

Principal findings: 71% (95% CI 68%-73%) of visits resulted in an antibiotic prescription. Patients in race-concordant visits were 17% (95% CI 8%-25%) less likely to receive a prescription.

Conclusions: Race-concordant outpatient visits were associated with more appropriate antibiotic use. Examination of characteristics such as concordance can improve our understanding of the prescribing process and inform stewardship efforts.