Physician Effects in Antibiotic Prescribing: Evidence from Physician Exits
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Physician Effects in Antibiotic Prescribing: Evidence from Physician Exits. / Huang, Shan; Ullrich, Hannes.
2021.Research output: Working paper › Research
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TY - UNPB
T1 - Physician Effects in Antibiotic Prescribing: Evidence from Physician Exits
AU - Huang, Shan
AU - Ullrich, Hannes
PY - 2021
Y1 - 2021
N2 - Human antibiotic consumption is considered the main driver of antibiotic resistance. Reducing human antibiotic consumption without compromising health care quality poses one of the most important global health policy challenges. A crucial condition for designing effective policies is to identify who drives antibiotic treatment decisions, physicians or patient demand. We measure the causal effect of physician practice style on antibiotic intake and health outcomes exploiting variation in patient-physician relations due to physician exits in general practice in Denmark. We estimate that physician practice style accounts for 53 to 56 percent of between-clinic differences in all antibiotic consumption, and for 74 to 81 percent in the consumption of second-line antibiotic drugs. We find little evidence that low prescribing styles adversely affect health outcomes measured as preventable hospitalizations due to infections. Our findings suggest that policies to curb antibiotic resistance are most effective when aimed at improving physician decision-making, in particular when they target high prescribers. High prescribing practice styles are positively associated with physician age and negatively with staff size and the availability of diagnostic tools, suggesting that improvements in the quality of diagnostic information is an important path to improved decisions.
AB - Human antibiotic consumption is considered the main driver of antibiotic resistance. Reducing human antibiotic consumption without compromising health care quality poses one of the most important global health policy challenges. A crucial condition for designing effective policies is to identify who drives antibiotic treatment decisions, physicians or patient demand. We measure the causal effect of physician practice style on antibiotic intake and health outcomes exploiting variation in patient-physician relations due to physician exits in general practice in Denmark. We estimate that physician practice style accounts for 53 to 56 percent of between-clinic differences in all antibiotic consumption, and for 74 to 81 percent in the consumption of second-line antibiotic drugs. We find little evidence that low prescribing styles adversely affect health outcomes measured as preventable hospitalizations due to infections. Our findings suggest that policies to curb antibiotic resistance are most effective when aimed at improving physician decision-making, in particular when they target high prescribers. High prescribing practice styles are positively associated with physician age and negatively with staff size and the availability of diagnostic tools, suggesting that improvements in the quality of diagnostic information is an important path to improved decisions.
KW - Faculty of Social Sciences
KW - Anotibiotic prescribing
KW - practice styles
KW - General Practitioners
U2 - 10.2139/ssrn.3895694
DO - 10.2139/ssrn.3895694
M3 - Working paper
T3 - DIW Berlin Discussion Paper
BT - Physician Effects in Antibiotic Prescribing: Evidence from Physician Exits
ER -
ID: 292144612