title: Physicians' perceptions about managed care restrictions on antibiotic prescribing.
abstract: The purpose of this study was to compare physicians' perceptions about managed care restrictions on drug prescribing with objective measures of the restrictions' effects. When asked a general question, 17 emergency medicine physicians in one urban, university hospital answered that they had to prescribe an antibiotic that was not their first choice because of managed care restrictions 32% of the time. The actual frequency of prescribing other than first-choice antibiotics, which was determined by asking the same physicians about the prescription of specific antibiotics for specific patients seen recently in the emergency department, was 6% ( p <.0001). We conclude that emergency medicine physicians treating patients in one managed care system significantly overestimated the restrictions imposed by managed care formularies on their antibiotic prescribing practices. Additional studies are warranted to measure the extent of this bias.
authors.affiliation: Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN 37232-4700, USA.
authors.forename: M
authors.initials: M
authors.lastname: Hasty
authors.forename: J
authors.initials: J
authors.lastname: Schrager
authors.forename: K
authors.initials: K
authors.lastname: Wrenn
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008329:Managed Care Programs / Q000592:standards*; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D013714:Tennessee; D014505:Urban Population
chemical_list: D000900:Anti-Bacterial Agents