Improving Care for Acute Respiratory Infections: Better Systems, Not Better Microbiology

Abstract

Americans made 1.17 billion visits to ambulatory clinics and emergency departments in 2005. Acute respiratory infections (i.e., nonspecific upper respiratory infections, otitis media, sinusitis, pharyngitis, bronchitis, influenza, and pneumonia) account for 11% of this total (130 million visits). This makes acute respiratory infections the most common symptomatic reason for seeking medical care in the United States. It is interesting that, despite the prevalence and impact of such infections on the health care system, no medical or scientific discipline seems to have taken “ownership” of acute respiratory infections. Acute respiratory infections should fall somewhere at the intersection of otolaryngology, pulmonary, and infectious diseases; alas, one doesn't perform surgery, bronchoscopy, or culture for most acute respiratory infections. Seventy percent of visits for acute respiratory infections are made to primary care physicians.