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Small area variations and welfare loss in the use of outpatient antibiotics

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Author Info
FILIPPINI, MASSIMO
MASIERO, GIULIANO
MOSCHETTI, KARINE

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Abstract

This article seeks to explain local variations in the use of antibiotics in the community and to assess the welfare loss due to heterogeneous attitudes towards the risk of bacterial resistance. Quarterly data on antibiotic sales from 240 small areas in Switzerland over the course of one year are used. An econometric ad-hoc model with spatial lags is proposed in which the demand for antibiotics varies according to the socioeconomic characteristics of the population, the incidence of infections, antibiotic price and local health care supply. Using residual variations we then evaluate the welfare loss due to varying antibiotic prescription styles. Significant differences are observed in the per capita antibiotic consumption across local areas. Individual income, the demographic structure of the population, physician density and the price of drugs are all relevant determinants. We estimate that unexplained variations may account for 12% of the total antibiotic spending in the community, thus leading to a 6.8 ml loss per year. Understanding the determinants of variations in outpatient antibiotic consumption may help to design more effective policies to counter the threat of bacterial resistance. Our estimate of the welfare loss due to heterogeneous attitudes towards antibiotic treatment is comparable to the expected cost of implementing measures to improve the dissemination of information on bacterial resistance among patients and doctors.

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Publisher Info
Article provided by Cambridge University Press in its journal Health Economics, Policy and Law.

Volume (Year): 4 (2009)
Issue (Month): 01 (January)
Pages: 55-77
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Handle: RePEc:cup:hecopl:v:4:y:2009:i:01:p:55-77_00

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  1. Massimo Filippini & Giuliano Masiero & Karine Moschetti, 2008. "Dispensing practices and antibiotic use," Quaderni della facoltà di Scienze economiche dell'Università di Lugano 0808, Biblioteca universitaria di Lugano (University Library of Lugano). [Downloadable!]
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This page was last updated on 2009-12-15.


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