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IID-5 Data Details

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IID-5 Reduce outpatient visits for ear infections where antibiotics were prescribed to young children

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Ambulatory Medical Care Survey (NAMCS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
77.8 (2006–07)
Target: 
70.0
Target-Setting Method: 
10 percent improvement
Target-Setting Method Justification: 
CDC’s public health campaign Get Smart: Know When Antibiotics Work is the focus of this measure. The campaign involves an alliance of partners working to reduce inappropriate antibiotic use and the spread of resistance to antibiotics. The campaign is continuing to grow partnership activities to increase public and health care provider awareness regarding appropriate antibiotic use. In addition, the campaign funded the update of pediatric prescribing guidelines that was published in 2011. The initial decreases in prescribing will be highest immediately following publication and dissemination of the guidelines. The anticipated overall decrease in prescribing attributed to the campaign is anticipated to be approximately 15 percent. This decrease in prescribing was estimated using historical data from NAMCS and NHAMCS. Data were fitted to a curve, taking into account the introduction of new guidelines and enhanced campaign efforts.
Numerator: 

Number of outpatient visits with an antibiotic course ordered, supplied, administered, or continued among children under age 5 years diagnosed with an ear infection (ICD-9-CM codes 381.0, 381.4, 382.0, 382.4, or 382.9)

Denominator: 

Number of outpatient visits for children under age 5 years diagnosed with an ear infection (ICD-9-CM codes 381.0, 381.4, 382.0, 382.4, or 382.9)

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Data Collection Frequency: 
Biennial
Methodology Notes: 

    The number of visits for ear infections among young children are the sum of cases reported by NAMCS and NHAMCS that have ear infections listed as any diagnosis (including the primary diagnosis).

Changes Between HP2010 and HP2020: 
This objective differs from Healthy People 2010 objective 14-18 in that the measure was revised from a population-based prescribing rate (prescriptions per 100 children) to a visit-based prescribing rate (percent of outpatient visits).

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2013, the unit of measurement changed from "percent" to "per 100" to be consistent with the objective statement. In 2013, a phrase was added to the denominator to clarify the target population which is children with an ear infection: diagnosed with an ear infection (ICD-9-CM codes 381.0, 381.4, 382.0, 382.4, or 382.9). The population estimates produced by the U.S. Census Bureau are used solely to weight the estimates produced by the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Care Survey. Consequently, in 2013, Population Estimates were removed from the list of Data Sources for this objective. In 2014, the measure was revised from a population-based prescribing rate (prescriptions per 100,000 population) to a visit-based prescribing rate (percent of outpatient visits) to be more aligned with the N/HAMCS data source and tol capture antibiotic prescribing behavior once a visit has occurred. As as result, the original baseline was revised from 48.7 per 100 children to 77.8 percent of visits. The target was adjusted from 37.0 per 100 children to 70.0 percent of visits to reflect the revised baseline using a new target-setting method: 10 percent improvement. 2008-09 follow-up data were also revised as a result of this methodology change.