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Assessing the impact of national antibiotic campaigns in Europe

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  • Massimo Filippini
  • González Ortiz, Laura G.
  • Giuliano Masiero

    ()

Abstract

Because of evidence of causal association between antibiotic use and bacterial resistance, the implementation of national policies has emerged as a interesting tool for controlling and reversing bacterial resistance. The aim of this study is to assess the impact of public policies on antibiotic use in Europe using a differences-in-differences approach. Comparable data on systemic administered antibiotics in 21 European countries are available for a 11-years panel between 1997 and 2007. Data on national campaigns are drawn from the public health literature. We estimate an econometric model of antibiotic consumption with country fixed effects and control for the main socioeconomic and epidemiological factors. Lagged values and the instrumental variables approach are applied to address endogeneity aspects of the prevalence of infections and the adoption of national campaigns. We find evidence that public campaigns significantly reduce the use of antimicrobials in the community by 1:3 to 5:6 defined daily doses per 1.000 inhabitants yearly. This roughly represents an impact between 6,5% and 28,3% on the mean level of antibiotic use in Europe between 1997 and 2007. The effect is robust across different measurement methods. Further research is needed to investigate the effectiveness of policy interventions targeting different social groups such as general practitioners or patients.

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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 1202.

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Date of creation: 2012
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Handle: RePEc:brh:wpaper:1202

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Keywords: Antibiotic use; public policies; national campaigns; difference-in-difference;

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References

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  1. Das, Jishnu & Sohnesen, Thomas Pave, 2006. "Patient satisfaction, doctor effort, and interview location : evidence from Paraguay," Policy Research Working Paper Series 4086, The World Bank.
  2. Giavazzi, Francesco & Tabellini, Guido, 2005. "Economic and political liberalizations," Journal of Monetary Economics, Elsevier, vol. 52(7), pages 1297-1330, October.
  3. Di Matteo, Livio, 2005. "The macro determinants of health expenditure in the United States and Canada: assessing the impact of income, age distribution and time," Health Policy, Elsevier, vol. 71(1), pages 23-42, January.
  4. Filippini, M. & Masiero, G. & Moschetti, K., 2009. "Regional consumption of antibiotics: A demand system approach," Economic Modelling, Elsevier, vol. 26(6), pages 1389-1397, November.
  5. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2002. "How Much Should We Trust Differences-in-Differences Estimates?," NBER Working Papers 8841, National Bureau of Economic Research, Inc.
  6. Arellano, M, 1987. "Computing Robust Standard Errors for Within-Groups Estimators," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 49(4), pages 431-34, November.
  7. L. G. Gonz�lez Ortiz & G. Masiero, 2013. "Disentangling spillover effects of antibiotic consumption: a spatial panel approach," Applied Economics, Taylor & Francis Journals, vol. 45(8), pages 1041-1054, March.
  8. Rudholm, Niklas, 2002. "Economic implications of antibiotic resistance in a global economy," Journal of Health Economics, Elsevier, vol. 21(6), pages 1071-1083, November.
  9. Carolyn Heinrich & Alessandro Maffioli & Gonzalo Vázquez, 2010. "A Primer for Applying Propensity-Score Matching," SPD Working Papers 1005, Inter-American Development Bank, Office of Strategic Planning and Development Effectiveness (SPD).
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Cited by:
  1. Blázquez-Fernández, Carla & González-Prieto, Noelia & Moreno-Mencía, Patricia, 2013. "Pharmaceutical Expenditure as a Determinant of Health Outcomes in EU Countries/El gasto farmacéutico como determinante de los resultados en salud en países de la UE," Estudios de Economía Aplicada, Estudios de Economía Aplicada, vol. 31, pages 379-396, Septiembr.
  2. Eibich, Peter & Ziebarth, Nicolas, 2013. "Examining the Structure of Spatial Health Effects using Hierarchical Bayes Models," Annual Conference 2013 (Duesseldorf): Competition Policy and Regulation in a Global Economic Order 79844, Verein für Socialpolitik / German Economic Association.

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