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Dispensing practices and antibiotic use

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  • Massimo Filippini
  • Giuliano Masiero

    ()

  • Karine Moschetti

Abstract

Regulation of prescription and dispensing of antibiotics has a twin purpose: to enhance access to antibiotic treatment and to reduce inappropriate use of drugs. Nevertheless, incentives on antibiotics to dispensing physicians may lead to inefficiencies. We sketch a theoretical model of the market for antibiotic treatment and empirically investigate the impact of self-dispensing on antibiotic consumption by means of spatial econometric estimators. The investigation exploits data from small geographic areas in a country where both regimes - with and without dispensing physicians - are possible. We find evidence that dispensing practices increase antibiotic use after controlling for determinants of demand and access, and spatial effects. This suggests that health authorities have a margin to adjust economic incentives on dispensing practices in order to reduce antibiotic misuse.

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File URL: http://hdl.handle.net/10446/695
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Bibliographic Info

Paper provided by Department of Economics and Technology Management, University of Bergamo in its series Working Papers with number 1006.

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Date of creation: 2010
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Handle: RePEc:brh:wpaper:1006

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Keywords: Physician dispensing; Prescribing behaviour; Antibiotic use;

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  1. Grytten, Jostein & Sorensen, Rune, 2003. "Practice variation and physician-specific effects," Journal of Health Economics, Elsevier, vol. 22(3), pages 403-418, May.
  2. Brekke, Kurt R. & Nuscheler, Robert & Straume, Odd Rune, 2002. "Quality and location choices under price regulation," Working Papers in Economics 24/02, University of Bergen, Department of Economics.
  3. Brekke, Kurt R. & Nuscheler, Robert & Straume, Odd Rune, 2007. "Gatekeeping in health care," Journal of Health Economics, Elsevier, vol. 26(1), pages 149-170, January.
  4. Fredrik Carlsen & Jostein Grytten, 1998. "More physicians: improved availability or induced demand?," Health Economics, John Wiley & Sons, Ltd., vol. 7(6), pages 495-508.
  5. Filippini, Massimo & Masiero, Giuliano & Moschetti, Karine, 2009. "Small area variations and welfare loss in the use of outpatient antibiotics," Health Economics, Policy and Law, Cambridge University Press, vol. 4(01), pages 55-77, January.
  6. Gravelle, Hugh & Masiero, Giuliano, 2000. "Quality incentives in a regulated market with imperfect information and switching costs: capitation in general practice," Journal of Health Economics, Elsevier, vol. 19(6), pages 1067-1088, November.
  7. Hunt-McCool, Janet & Kiker, B F & Ng, Ying Chu, 1994. "Estimates of the Demand for Medical Care under Different Functional Forms," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 9(2), pages 201-18, April-Jun.
  8. Izabela Jelovac, 2001. "Physicians' payment contracts, treatment decisions and diagnosis accuracy," Health Economics, John Wiley & Sons, Ltd., vol. 10(1), pages 9-25.
  9. Michael Baye & Robert Maness & Steven Wiggins, 1997. "Demand systems and the true subindex of the cost of living for pharmaceuticals," Applied Economics, Taylor & Francis Journals, vol. 29(9), pages 1179-1190.
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