Association Between US News & World Report Medical School Ranking and Physician Opioid Prescribing for New Low Back Pain, 2011–2014
Prior research has found significant physician variation in opioid prescribing.1 Some research has found that primary care physicians (PCPs) who attended a higher-ranked medical school wrote significantly fewer opioid prescriptions overall than PCPs who attended a lower-ranked school.2 Whether an association persists between medical school ranking and opioid prescribing when examining a more clinically defined scenario—patients who develop new low back pain—is unknown.
We performed analyses using 2010–2014 claims data for a random 20% sample of Medicare beneficiaries. We included beneficiaries aged 66 and over continuously enrolled in Medicare Parts A, B, and D the year prior, year of, and year subsequent to their episode of new low back pain with no opioid exposure in the prior 365 days. We excluded patients with history of cancer or a hospice claim. The outcome was opioid use in the subsequent 365 days, defined both as a binary variable for ever received and as a...
The author wishes to thank Samantha L. Burn, Aaron L. Schwartz, Alyssa Bilinski, and Atheendar S. Venkataramani for their helpful comments on the paper.
This work was supported by the National Institute on Aging (Grant F32 AG060650-01).
Compliance with Ethical Standards
We obtained study approval from the National Bureau of Economic Research, where the data are housed.
Conflict of Interest
The author declares that he does not have a conflict of interest.
No funding source played a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
- 3.Center for Medicare and Medicaid Services. Opioid oral morphine equivalent (MME) conversion factors. 2017. https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/Downloads/Opioid-Morphine-EQ-Conversion-Factors-April-2017.pdf. Accessed September 6, 2019.
- 4.Center for Medicare and Medicaid Services. Physician Compare datasets. 2019. https://data.medicare.gov/data/physician-compare. Accessed September 6, 2019.