Physician Effects in Antibiotic Prescribing: Evidence from Physician Exits

62 Pages Posted: 2 Aug 2021

See all articles by Shan Huang

Shan Huang

German Institute for Economic Research (DIW Berlin)

Hannes Ullrich

German Institute for Economic Research (DIW Berlin) - Innovation, Management, Service; University of Copenhagen - Department of Economics

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Date Written: July 2021

Abstract

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.

Keywords: I11,J44,I12

JEL Classification: Antibiotic prescribing, practice styles, general practitioners

Suggested Citation

Huang, Shan and Ullrich, Hannes and Ullrich, Hannes, Physician Effects in Antibiotic Prescribing: Evidence from Physician Exits (July 2021). DIW Berlin Discussion Paper No. 1958, Available at SSRN: https://ssrn.com/abstract=3895694 or http://dx.doi.org/10.2139/ssrn.3895694

Shan Huang

German Institute for Economic Research (DIW Berlin) ( email )

Mohrenstraße 58
Berlin, 10117
Germany

Hannes Ullrich (Contact Author)

University of Copenhagen - Department of Economics ( email )

Øster Farimagsgade 5, Bygn 26
Copenhagen, 1353
Denmark

German Institute for Economic Research (DIW Berlin) - Innovation, Management, Service ( email )

Mohrenstraße 58
Berlin, 10117
Germany
+493089789521 (Phone)

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