Continuous Improvement and the Expansion of Quality ... - NCQA

M E A S U R E S T A R G E T E D A T C H I l D R E N A N D A D o l E S C E N T S
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N AT I o N A l C o M M I T T E E f o R Q U A l I T y A S S U R A N C E
APPRoPRIATE TREATMENT foR CHIlDREN
WITH UPPER RESPIRAToRy INfECTIoN
Upper respiratory infections (URI) are self-regulating viral infections that cannot be treated
by antibiotics. 1 Despite this, clinical practice trends show that antibiotics are often prescribed,
leading to a trend in overuse and growing antimicrobial resistance among patients. 1 Also known
as the “common cold,” URIs target the lining of the throat and nose, resulting in fever, congestion,
coughing and other symptoms. 2 The Appropriate Treatment for Children With Upper Respiratory
Infection measure evaluates whether children were properly treated for URIs by not receiving
antibiotics unless deemed appropriate by a clinician.
• Approximately over 100 million antibiotic
prescriptions are written in the ambulatory
care setting every year. 3
• According to the Centers for Disease
Control and Prevention, antibiotics were
prescribed during 68 percent of URI visits.
of these visits, 80 percent did not require
the prescription of antibiotics as defined by
practice guidelines. 4
• In 2005, there were 1.17 billion visits
to ambulatory clinics and emergency
departments. 11 percent (130 million visits)
were for acute respiratory infections. 7
the Case for Improvement
• In the U.S., URIs are responsible for
nearly $17 billion in direct costs (e.g.,
physician services and treatment because
of complications) and $22.5 billion in
indirect costs (e.g., absenteeism and lost
productivity) every year. 6
• Studies have shown that up to 60 percent
of patients with colds or URIs seen in the
emergency department are prescribed
antibiotics, which have not demonstrated
improvement in clinical outcomes. 5
• overuse of antibiotics is a significant issue
in URI treatment. A survey conducted
in 2004 illustrated that among children
seen in a primary practice, outpatient
or emergency department setting, those
diagnosed with viral URIs experienced
even higher rates of antibiotic prescription,
even though antibiotics are ineffective for
treating viral infections. 8