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Assessing the impact of national antibiotic campaigns in Europe

  • M. Filippini
  • L. Ortiz
  • G. Masiero

    ()

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 was to assess the impact of public policies on antibiotic use in Europe using a differences-in-differences approach. Comparable data on systemic antibiotics administered in 21 European countries are available for a 11-year period 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 1.3–5.6 defined daily doses per 1,000 inhabitants yearly. This represents an impact of roughly 6.5–28.3 % 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. Copyright Springer-Verlag 2013

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File URL: http://hdl.handle.net/10.1007/s10198-012-0404-9
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Article provided by Springer in its journal The European Journal of Health Economics.

Volume (Year): 14 (2013)
Issue (Month): 4 (August)
Pages: 587-599

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Handle: RePEc:spr:eujhec:v:14:y:2013:i:4:p:587-599
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  1. Francesco Giavazzi & Guido Tabellini, 2004. "Economic and Political Liberalizations," CESifo Working Paper Series 1249, CESifo Group Munich.
  2. 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).
  3. 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.
  4. 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.
  5. Rudholm, Niklas, 2002. "Economic implications of antibiotic resistance in a global economy," Journal of Health Economics, Elsevier, vol. 21(6), pages 1071-1083, November.
  6. 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.
  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. 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.
  9. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-in-Differences Estimates?," The Quarterly Journal of Economics, MIT Press, vol. 119(1), pages 249-275, February.
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