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Understanding antibiotic overprescribing in China: A conversation analysis approach

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  • Wang, Nan Christine

Abstract

Antibiotic resistance and its associated overprescription constitute one of the biggest global public health crises nowadays. Although widely recognized in high-income countries, the problem has not received enough attention and is not understood in the context of middle- and low-income countries. In this study, using a conversation analysis (CA) approach, I examine the antibiotic treatment decisions in naturally occurring medical encounters in China. The results show that, contrary to the prevailing theory of the physician incentive structure as the sole driver, antibiotic overprescription can be interactively achieved and significantly influenced by patients and caregivers in medical encounters. This suggests that management of patient caregivers' expectations for antibiotic treatment and the training of physicians’ interactional skills in responding to patient/caregiver pressure in medical interactions have great potential for curbing the problem of antibiotic overprescription in China.

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  • Wang, Nan Christine, 2020. "Understanding antibiotic overprescribing in China: A conversation analysis approach," Social Science & Medicine, Elsevier, vol. 262(C).
    • Handle: RePEc:eee:socmed:v:262:y:2020:i:c:s0277953620304706
    DOI: 10.1016/j.socscimed.2020.113251
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    References listed on IDEAS

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    1. Currie, Janet & Lin, Wanchuan & Zhang, Wei, 2011. "Patient knowledge and antibiotic abuse: Evidence from an audit study in China," Journal of Health Economics, Elsevier, vol. 30(5), pages 933-949.
    2. Bi, Peng & Tong, Shilu & Parton, Kevin A., 2000. "Family self-medication and antibiotics abuse for children and juveniles in a Chinese city," Social Science & Medicine, Elsevier, vol. 50(10), pages 1445-1450, May.
    3. Reynolds, Lucy & McKee, Martin, 2009. "Factors influencing antibiotic prescribing in China: An exploratory analysis," Health Policy, Elsevier, vol. 90(1), pages 32-36, April.
    4. Stivers, Tanya, 2002. "Participating in decisions about treatment: overt parent pressure for antibiotic medication in pediatric encounters," Social Science & Medicine, Elsevier, vol. 54(7), pages 1111-1130, April.
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    1. Wang, Nan Christine & Liu, Yuetong, 2021. "Going shopping or consulting in medical visits: Caregivers’ roles in pediatric antibiotic prescribing in China," Social Science & Medicine, Elsevier, vol. 290(C).
    2. Bergen, Clara & McCabe, Rose, 2021. "Negative stance towards treatment in psychosocial assessments: The role of personalised recommendations in promoting acceptance," Social Science & Medicine, Elsevier, vol. 290(C).
    3. Wang, Sophie Y. & Cantarelli, Paola & Groene, Oliver & Stargardt, Tom & Belle, Nicola, 2023. "Patient expectations do matter - Experimental evidence on antibiotic prescribing decisions among hospital-based physicians," Health Policy, Elsevier, vol. 128(C), pages 11-17.

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