scholarly journals 1359. Utilization of West Virginia Pediatric Medicaid Claims Data to Guide Outpatient Antimicrobial Stewardship Interventions

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S691-S691
Author(s):  
Jacob T Kilgore ◽  
Mariana M Lanata Piazzon ◽  
Jonathan M Willis ◽  
Joseph Evans ◽  
Michael J Smith
Keyword(s):  
Information System ◽  
Geographic Information System ◽  
West Virginia ◽  
Pediatric Patients ◽  
Antibiotic Use ◽  
Gis Mapping ◽  
Oral Antibiotic ◽  
Research Support ◽  
Prescription Rates ◽  
Race Ethnicity

Abstract Background Antimicrobial resistance is a significant public health risk with overuse and misuse of antibiotics as primary drivers. West Virginia (WV) leads the nation in per capita prescribing in the outpatient setting, where the majority of antibiotic use occurs. Methods We analyzed outpatient pharmacy and medical claims for WV Medicaid recipients age < 20 years from 1/1/2018 – 12/31/2019. Dental claims were excluded. Oral antibiotics were identified using National Drug Codes (NDCs). Key demographic variables extracted from the claims include patient age (as of December 31st of that calendar year [CY]), sex, race, ethnicity, Medicaid region, place of medical service, provider, and cost. Rates of prescribing were calculated as the number of prescriptions per 1,000 children and stratified by age, race/ethnicity, sex, and WV Medicaid region. We used geographic information system (GIS) mapping to depict geographic variation in prescribing by county. Oral antibiotic prescriptions were compared across CY 2018 and 2019 including spectrum of antibiotic coverage. Results In CY 2018, 204,576 pediatric patients received 237,759 antibiotics (1,162 prescriptions/1,000 children). In 2019, 201,520 pediatric patients received 227,440 antibiotics (1,129 prescriptions/1,000 children). Prescription rates were higher among females, Caucasians and a younger (0-2) age group (Table 1). Antibiotics were more commonly prescribed by non-physician (e.g. nurse practitioner, etc.), non-pediatric specialty providers. Amoxicillin, cefdinir, and azithromycin were the most commonly prescribed antibiotics across CYs. Table 2 summarizes commonly prescribed antibiotics and their associated cost. Medicaid region 4 encompassed the highest prescription rates. Figure 1 is a GIS map of prescription rates by WV county. Table 1. West Virginia pediatric (0 – 19 years*) Medicaid patient population demographic summary by calendar year (CY). Table 2. Oral antibiotic prescription review including cost, CY 2018-2019. Figure 1. Geographic information system (GIS) mapping of prescriptions per 1,000 children by WV county. Conclusion There is significant variation in antibiotic prescribing across WV. Potential areas of stewardship intervention should focus on non-physician, non-pediatric providers in Medicaid Region 4, the southern and arguably most rural portion of the state. Secondary analysis revealed an alarmingly high total number of broad-spectrum antibiotic use compared to narrow-spectrum. Further data analysis will examine diagnosis-specific prescription practices within this population. Disclosures Michael J. Smith, MD, MSC.E, Kentucky Medicaid (Grant/Research Support)Merck (Grant/Research Support)

scholarly journals 1351. Pediatric Antibioitic Use in the North Carolina Medicaid Population

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S686-S686
Author(s):  
Rebecca R Young ◽  
Paul Lantos ◽  
Paul Lantos ◽  
Michael J Smith
Keyword(s):  
North Carolina ◽  
Metropolitan Area ◽  
Metropolitan Areas ◽  
Antibiotic Use ◽  
The United States ◽  
The State ◽  
Gis Mapping ◽  
Antibiotic Prescribing ◽  
Research Support ◽  
Race Ethnicity

Abstract Background Antimicrobial resistance is increasing in the United States, with antibiotic use as the main driver. The majority of antibiotic use occurs in the outpatient setting. 6 of the 7 highest prescribing states are located in the Appalachian region of the country. Overall, the state of North Carolina (NC) has prescribing rates that are at the national average, but the geographic, patient and provider-level characteristics associated with antibiotic prescribing within the state are unknown. Methods We used NC Medicaid claims from 2013-2018 to identify oral antibiotics prescribed to children, defined as individuals < 21 years. Antibiotics were identified using National Drug Codes. Overall rates of antibiotic prescribing were reported as the number of prescriptions per 1000 children overall and stratified by age, sex, race/ethnicity and residence in a metropolitan area. Provider characteristics and setting type were identified using existing variables in the Medicaid dataset. A geographic information system was used to graphically depict rates of antibiotic use by county. Results Rates of prescribing decreased from 724/1000 children in 2013 to 578/1000 children in 2018. Across all study years there were differences in prescribing rates by sex, race/ethnicity, age and residence in a metropolitan area. (Table) Prescriptions were more common in children who were younger (0-2), white non-Hispanic, female and living in non-metropolitan areas. Prescribing rates were geographically heterogeneous, with the highest rates in the western mountain region and declining across a west to east gradient. (Figure) Most (62%) antibiotic prescriptions were written in the primary care setting. Pediatricians prescribed 48% of all antibiotic courses. Antibiotic Prescriptions Per 1000 Children, by Demographic Group (2013-2018) Antibiotic Prescriptions per 1000 Children, by County (2013-2018) Conclusion Although NC is not a high-prescribing state in general, we found notable difference in prescribing based on key demographic characteristics. These results are consistent with prior reports from other Appalachian states including Kentucky, West Virginia and Tennessee. Rates of prescription were highest in non-metropolitan areas overall but GIS mapping revealed a marked west-east gradient. These data suggest that specific Appalachian characteristics, rather than rurality alone, may be associated with excessive antibiotic prescribing. Disclosures Michael J. Smith, MD, MSC.E, Kentucky Medicaid (Grant/Research Support)Merck (Grant/Research Support)

scholarly journals Association Between Outpatient Antibiotic Prescribing Practices and Community-Associated Clostridium difficile Infection

2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Raymund Dantes ◽  
Yi Mu ◽  
Lauri A. Hicks ◽  
Jessica Cohen ◽  
Wendy Bamberg ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Healthcare Providers ◽  
Population Level ◽  
Healthcare Facility ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Oral Antibiotic ◽  
Prescribing Practices ◽  
Active Population ◽  
Prescription Rates

Abstract Background.  Antibiotic use predisposes patients to Clostridium difficile infections (CDI), and approximately 32% of these infections are community-associated (CA) CDI. The population-level impact of antibiotic use on adult CA-CDI rates is not well described. Methods.  We used 2011 active population- and laboratory-based surveillance data from 9 US geographic locations to identify adult CA-CDI cases, defined as C difficile-positive stool specimens (by toxin or molecular assay) collected from outpatients or from patients ≤3 days after hospital admission. All patients were surveillance area residents and aged ≥20 years with no positive test ≤8 weeks prior and no overnight stay in a healthcare facility ≤12 weeks prior. Outpatient oral antibiotic prescriptions dispensed in 2010 were obtained from the IMS Health Xponent database. Regression models examined the association between outpatient antibiotic prescribing and adult CA-CDI rates. Methods.  Healthcare providers prescribed 5.2 million courses of antibiotics among adults in the surveillance population in 2010, for an average of 0.73 per person. Across surveillance sites, antibiotic prescription rates (0.50–0.88 prescriptions per capita) and unadjusted CA-CDI rates (40.7–139.3 cases per 100 000 persons) varied. In regression modeling, reducing antibiotic prescribing rates by 10% among persons ≥20 years old was associated with a 17% (95% confidence interval, 6.0%–26.3%; P = .032) decrease in CA-CDI rates after adjusting for age, gender, race, and type of diagnostic assay. Reductions in prescribing penicillins and amoxicillin/clavulanic acid were associated with the greatest decreases in CA-CDI rates. Conclusions and Relevance.  Community-associated CDI prevention should include reducing unnecessary outpatient antibiotic use. A modest reduction of 10% in outpatient antibiotic prescribing can have a disproportionate impact on reducing CA-CDI rates.

scholarly journals Response to Poliovirus Outbreaks in the Lake Chad Sub-Region: A GIS Mapping Approach

2021 ◽  
Vol Special Issue (2) ◽  
pp. 94-101
Author(s):  
Atagbaza Ajiri ◽  
Joseph Okeibunor ◽  
Samuel Aiyeoribe ◽  
Benoit Ntezayabo ◽  
Melinda Mailhot ◽  
...  
Keyword(s):  
Information System ◽  
Feature Extraction ◽  
Geographic Information System ◽  
High Resolution ◽  
Polio Eradication ◽  
Geographical Information ◽  
Online Resources ◽  
Gis Mapping ◽  
Review Of Literature ◽  
Lake Chad

The geographic information system (GIS) mapping was used to improve the efficiency of vaccination teams. This paper documents the process in the deployment of geographical information system in response to polio eradication in Chad. It started with a careful review of government official documents as well as review of literature and online resources on Chad, which confirmed that official boundaries existed at two levels, namely Regions and Districts. All settlement locations in the target Districts were identified by manual feature extraction of high-resolution, recent satellite imagery, and map layers created for the following categories: hamlets, hamlet areas, small settlements, and built-up areas (BUAs). This clearly improved microplanning and provided valuable feedback in identifying missed settlements, leading to increased coverage and fewer missed children.

scholarly journals JOURNAL GEOGRAFIC INFORMATION SYSTEM (GIS) MAPPING THE LOCATION OF TAILORS IN THE CITY OF TEMBILAHAN WEB-BASED

2021 ◽  
Vol 3 (3) ◽  
pp. 84-97
Author(s):  
Nurita Suwanti ◽  
Usman
Keyword(s):  
Information System ◽  
Geographic Information System ◽  
System Development ◽  
Unified Modeling Language ◽  
Complete Information ◽  
Geographic Information ◽  
Geographical Information ◽  
Gis Mapping ◽  
Gis Technology ◽  
The Public

Currently, there are many information systems that are used to support and solve a problem that usually arises in an organization, company or government agency. One of them is Geographic Information System (GIS) technology which has developed rapidly. Where this system can be a means for delivering information on the location of the location, especially those related to the business of tailoring clothes. This geographic information system for mapping the location of the tailor's location aims to analyze, design and build a geographic information system for mapping the location that can convey information on the location of the tailor, convey complete information about the tailor's location so that it can be spread thoroughly to the public or system users, provide useful information to the public in the process of finding the location of tailors in Tembilahan city based on precise and accurate data. In designing the GIS mapping of the tailor's location, Waterfall is a system development method that functions as a mechanism to identify software, as well as UML (Unified Modeling Language) as modeling, and uses the PIECES method to facilitate researchers in building systems. With the geographical information system mapping the location of this tailor, the delivery of information about the tailor's place can be spread thoroughly to the community or system users.   Keywords:  System, Information, Geographic Information System, Tailor,WebGis.  

Geographic information system analysis of developmentally disabled adult offenders

2016 ◽  
Vol 7 (1) ◽  
pp. 4-13
Author(s):  
George Steve Tsagaris ◽  
Mamadou Mansor Seck ◽  
Janet Keeler ◽  
Robert Rowe
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Information System ◽  
Geographic Information System ◽  
System Analysis ◽  
Geographic Information ◽  
Mental Health Court ◽  
Gis Mapping ◽  
Community Control ◽  
Content Type

Purpose – Adult offenders diagnosed with developmental disabilities have been referred for services to a Northeast Ohio county agency. The purpose of this paper is to examine their repartition in the three areas of the county as determined by zip codes, their involvement with the criminal justice system, types of offenses they committed, their indictment, and the court outcomes. Design/methodology/approach – This study used a geographic information system (GIS) mapping based on secondary data collected from the 2008 to 2012 American Community Survey and a random sample of 160 participants selected from an agency database including 850 clients. Findings – The authors found that the concentrations of offenders in the core city, inner, and outer suburbs of the county were, respectively 71.7, 19.6, and 8.7 percent. The largest racial groups included African Americans (112; 70 percent) and Whites (33; 20.6 percent). Male offenders (155; 96.9 percent) outnumbered female offenders. Of the offenses committed, 42.9 percent were crimes against persons including kidnapping, abduction, assault, followed by crimes against property (22.2 percent), and crimes against society (26.4 percent). As they appeared before Mental Health Court or Non Mental Health Court judges, the court outcome evolved from community control for six months to prison sentence of 120 months. Research limitations/implications – These findings will enable agency professionals to look for protective as well as risk factors that are prevalent in each area of this NEO county and make plans for more effective, preventative, and clinical service provision. Originality/value – The use of GIS for data analysis represents an innovation in the research field involving adult offenders with developmental disability as it allows professionals to look for protective as well as risk factors that are prevalent in their clients’ immediate environment.

Use of Geographic Information System Mapping in the Examination of Specialized Low Vision Resources and Areas of Need in Michigan

2021 ◽  
Vol 115 (1) ◽  
pp. 5-16
Author(s):  
Elyse Connors ◽  
Amber E. Willard ◽  
Kathleen M. Baker ◽  
Katie Debiak ◽  
Renee Beranek ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Information System ◽  
Geographic Information System ◽  
Vision Loss ◽  
Low Vision ◽  
Public Health Problem ◽  
Geographic Information ◽  
Gis Mapping ◽  
Lower Peninsula

Introduction: The number of adults with visual impairments (i.e., blindness or low vision) is increasing, especially with the aging of the population. Although awareness of vision loss as a public health problem is growing, public health budgets are decreasing. This study exemplifies the use of publicly available secondary data and geographic information system (GIS) mapping to spatially map areas of potential higher risk for vision loss and identify where specialized, low vision resources are located, by county, in Michigan. Methods: County-level, publicly available data on risk factors for low vision (health and demographic) and specialized low vision resources (medical, rehabilitation, and community) are extracted from existing public health data sets and information published on the Internet. GIS mapping is applied to visually examine potential areas of disparity between need and resources. Results: Broadly speaking, counties in Michigan with the highest number of risk factors for low vision are clustered in the center of the Lower Peninsula and on the eastern and western ends of the Upper Peninsula. Areas that have fewer resources for low vision are clustered in the thumb area and the middle to upper part of the Lower Peninsula. Resources are concentrated near the state’s metropolitan areas (i.e., Detroit and suburbs, Kalamazoo, and Grand Rapids). Discussion: Maps can be helpful in locating areas of health disparities, but they need to be interpreted carefully such as by considering the county’s population size. Understanding the eligibility criteria of available services can help to uncover groups of persons not being served. Implications for practitioners: With increasing need for services and shrinking budgets, strategic planning may help alleviate anticipated shortfalls in available services. Use of publicly available data and GIS mapping may be an affordable and efficient method to identify areas of need and resources, for targeted public health efforts in vision.

Pesticide toxicity assessment and geographic information system (GIS) application in small-scale rice farming operations, Thailand

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Ekarat Sombatsawat ◽  
Dana Boyd Barr ◽  
Parinya Panuwet ◽  
Mark Gregory Robson ◽  
Wattasit Siriwong
Keyword(s):  
Information System ◽  
Geographic Information System ◽  
Pesticide Exposure ◽  
Toxicity Assessment ◽  
Geographic Information ◽  
Gis Mapping ◽  
Small Scale ◽  
Rice Farming ◽  
Residential Areas ◽  
The Impact

AbstractThe objectives of the study were to evaluate the impact of pesticide exposure on farmer health during non-active rice farming and active rice farming periods and present the change in the individual cholinesterase activities (%reduction) on the geographic information system (GIS) mapping in Nakhon Ratchasima Province, Thailand. Acetyl- and butyryl-cholinesterase (AChE and BuChE) activities were monitored during both study periods using Test-mate ChE (Model 400). The location of paddy fields was specified using Garmin geographic positioning system MAP 62s. Fifty-eight farmers who participated in this study had an average age of 49.2 ± 6.9 years. Higher prevalence of all health symptoms was observed among farmer participants during the active rice farming period comparing to the non-active rice farming period (p < 0.01). Furthermore, farmers had significantly lower activities of AChE and BuChE during the active rice farming period comparing to the non-active rice farming period (p < 0.01). Our findings indicate that the GIS mapping indicate that the cases with a significant enzyme inhibition have dispersed across the agricultural and the nearby residential areas. This, investigation can be used to promote safer use of pesticides among farmers and mitigate pesticide exposure among residents living in close proximity to a rice field.

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