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

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  • FILIPPINI, MASSIMO
  • MASIERO, GIULIANO
  • MOSCHETTI, KARINE

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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  • 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.
  • Handle: RePEc:cup:hecopl:v:4:y:2009:i:01:p:55-77_00
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    1. Kaestner, R. & Joyce, T. & Racine, A., 2001. "Medicaid eligibility and the incidence of ambulatory care sensitive hospitalizations for children," Social Science & Medicine, Elsevier, vol. 52(2), pages 305-313, January.
    2. Kristine A. Lykens & Paul A. Jargowsky, 2002. "Medicaid matters: children's health and medicaid eligibility expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 21(2), pages 219-238.
    3. Cameron,A. Colin & Trivedi,Pravin K., 2008. "Microeconometrics," Cambridge Books, Cambridge University Press, number 9787111235767, March.
    4. Dahlberg, Matz & Lundin, Douglas, 2005. "Antidepressants and the Suicide Rate: Is There Really a Connection?," Working Paper Series 2005:4, Uppsala University, Department of Economics.
    5. Jens Ludwig & Dave E. Marcotte, 2005. "Anti-depressants, suicide, and drug regulation," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 24(2), pages 249-272.
    6. Kaestner, Robert & Dubay, Lisa & Kenney, Genevieve, 2005. "Managed care and infant health: an evaluation of Medicaid in the US," Social Science & Medicine, Elsevier, vol. 60(8), pages 1815-1833, April.
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    Cited by:

    1. Massimo Filippini & Giuliano Masiero & Karine Moschetti, 2008. "Dispensing practices and antibiotic use," Quaderni della facoltà di Scienze economiche dell'Università di Lugano 0808, USI Università della Svizzera italiana.
    2. Rönnerstrand, Björn & Andersson Sundell, Karolina, 2015. "Trust, reciprocity and collective action to fight antibiotic resistance. An experimental approach," Social Science & Medicine, Elsevier, vol. 142(C), pages 249-255.
    3. 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.
    4. Filippini, M. & Heimsch, F. & Masiero, G., 2014. "Antibiotic consumption and the role of dispensing physicians," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 242-251.
    5. M. Filippini & G. Masiero, 2012. "An empirical analysis of habit and addiction to antibiotics," Empirical Economics, Springer, vol. 42(2), pages 471-486, April.
    6. Laura González & Giuliano Masiero, 2011. "Disentangling spillover effects of antibiotic consumption: a spatial panel approach," Quaderni della facoltà di Scienze economiche dell'Università di Lugano 1106, USI Università della Svizzera italiana.
    7. Massimo Filippini & Giuliano Masiero & Karine Moschetti, 2009. "Physician dispensing and antibiotic prescriptions," Quaderni della facoltà di Scienze economiche dell'Università di Lugano 0908, USI Università della Svizzera italiana.

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