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

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  • Massimo Filippini

    (Department of Management, Technology and Economics, ETH Zurich, Switzerland)

  • Giuliano Masiero

    () (Department of Management and Information Technology, University of Bergamo, Italy)

  • Karine Moschetti

    (Institute for Microeconomics and Public Economics (MecoP), University of Lugano, Switzerland)

Abstract

This paper 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 infections and resistance. Significant differences are observed in the per capita antibiotic consumption measured in defined daily doses per 1000 inhabitants (DID) across small geographic areas in Switzerland. A model is proposed in which antibiotic use varies according to the socioeconomic characteristics of the population, the incidence of infections, antibiotic price and local supply of health care. Quarterly wholesales data on outpatient antibiotics in 2002 were obtained from IHA-IMS Market Research and combined with WHO standardized doses to obtain DID. The paper finds that the most important determinants of variations in outpatient antibiotics use in the community are income, demographic structure of the population and local supply and price of antibiotic treatment. We estimated that unexplained variations may account for 11% of the total antibiotic spending in the community, thus leading to a €6ml loss per year.

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File URL: http://doc.rero.ch/lm.php?url=1000,42,6,20061020101357-WN/wp0607.pdf
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Bibliographic Info

Paper provided by USI Università della Svizzera italiana in its series Quaderni della facoltà di Scienze economiche dell'Università di Lugano with number 0607.

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Length: 27 pages
Date of creation: Oct 2006
Date of revision:
Handle: RePEc:lug:wpaper:0607

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Web page: http://www.library.lu.usi.ch

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Keywords: antibiotic use; small area variations; welfare loss;

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  1. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536 Elsevier.
  2. Grytten, Jostein & Sorensen, Rune, 2003. "Practice variation and physician-specific effects," Journal of Health Economics, Elsevier, vol. 22(3), pages 403-418, May.
  3. Filippini, Massimo & Masiero, Giuliano & Moschetti, Karine, 2006. "Socioeconomic determinants of regional differences in outpatient antibiotic consumption: Evidence from Switzerland," Health Policy, Elsevier, vol. 78(1), pages 77-92, August.
  4. Folland, Sherman & Stano, Miron, 1989. "Sources of small area variations in the use of medical care," Journal of Health Economics, Elsevier, vol. 8(1), pages 85-107, March.
  5. Joines, Jerry D. & Hertz-Picciotto, Irva & Carey, Timothy S. & Gesler, Wilbert & Suchindran, Chirayath, 2003. "A spatial analysis of county-level variation in hospitalization rates for low back problems in North Carolina," Social Science & Medicine, Elsevier, vol. 56(12), pages 2541-2553, June.
  6. Stano, Miron, 1993. "Evaluating the policy role of the small area variations and physician practice style hypotheses," Health Policy, Elsevier, vol. 24(1), pages 9-17, April.
  7. Martin, Stephen & Smith, Peter, 1996. "Explaining variations in inpatient length of stay in the National Health Service," Journal of Health Economics, Elsevier, vol. 15(3), pages 279-304, June.
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