IDEAS home Printed from https://ideas.repec.org/p/has/discpr/1810.html
   My bibliography  Save this paper

Primary care availability affects antibiotic consumption – Evidence using unfilled positions in Hungary

Author

Listed:
  • Aniko Biro

    (Institute of Economics, Centre for Economic and Regional Studies, Hungarian Academy of Sciences)

  • Peter Elek

    (Department of Economics, Eörvös Loránd University (ELTE), Budapest, Hungary)

Abstract

Using administrative data from Hungary, we analyse the effect of general practitioner (GP) care availability on the consumption of antibiotics. We exploit the geographical and time variation in unfilled GP positions as a source of exogenous variation in the availability of primary care. According to our estimates from fixed effects panel regressions, if the single GP position of a village becomes unfilled, the days of therapy (DOT) as well as public expenditures on antibiotics decrease by 3.2-4.1%. The negative effect on antibiotic consumption is stronger in smaller settlements, in settlements where secondary care is less available, and where antibiotics were previously overprescribed. The quality of prescribing behaviour measured by the ratio of narrow-spectrum to broad-spectrum antibiotics deteriorates significantly as a consequence of worse primary care availability. The number of GP consultations decreases by 9.8%, but prescribed antibiotic DOT per GP visit goes up by 7.2%.

Suggested Citation

  • Aniko Biro & Peter Elek, 2018. "Primary care availability affects antibiotic consumption – Evidence using unfilled positions in Hungary," CERS-IE WORKING PAPERS 1810, Institute of Economics, Centre for Economic and Regional Studies.
    • Handle: RePEc:has:discpr:1810
    as

    Download full text from publisher

    File URL: https://www.mtakti.hu/wp-content/uploads/2018/06/MTDP1810.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. 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.
    2. Giuliano Masiero & Massimo Filippini & Matus Ferech & Herman Goossens, 2010. "Socioeconomic determinants of outpatient antibiotic use in Europe," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 55(5), pages 469-478, October.
    3. Haynes, R. M. & Bentham, C. G., 1982. "The effects of accessibility on general practitioner consultations, out-patient attendances and in-patient admissions in Norfolk, England," Social Science & Medicine, Elsevier, vol. 16(5), pages 561-569, January.
    4. Péter Elek & Balázs Váradi & Márton Varga, 2015. "Effects of Geographical Accessibility on the Use of Outpatient Care Services: Quasi‐Experimental Evidence from Panel Count Data," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1131-1146, September.
    5. Martin Blaser, 2011. "Stop the killing of beneficial bacteria," Nature, Nature, vol. 476(7361), pages 393-394, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. M. Filippini & G. Masiero, 2012. "An empirical analysis of habit and addiction to antibiotics," Empirical Economics, Springer, vol. 42(2), pages 471-486, April.
    3. Breno S Kliemann & Anna S Levin & M Luísa Moura & Icaro Boszczowski & James J Lewis, 2016. "Socioeconomic Determinants of Antibiotic Consumption in the State of São Paulo, Brazil: The Effect of Restricting Over-The-Counter Sales," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-14, December.
    4. M. Filippini & L. Ortiz & G. Masiero, 2013. "Assessing the impact of national antibiotic campaigns in Europe," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(4), pages 587-599, August.
    5. Maria Michela Gianino & Jacopo Lenzi & Marco Bonaudo & Maria Pia Fantini & Walter Ricciardi & Gianfranco Damiani, 2018. "Predictors and trajectories of antibiotic consumption in 22 EU countries: Findings from a time series analysis (2000–2014)," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-11, June.
    6. L. G. González 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.
    7. Silvia Portero de la Cruz & Jesús Cebrino, 2020. "Prevalence and Determinants of Antibiotic Consumption in the Elderly during 2006–2017," IJERPH, MDPI, vol. 17(9), pages 1-16, May.
    8. Bíró, Anikó & Elek, Péter, 2020. "Job loss, disability insurance and health expenditure," Labour Economics, Elsevier, vol. 65(C).
    9. Péter Elek & Tamás Molnár & Balázs Váradi, 2019. "The closer the better: does better access to outpatient care prevent hospitalization?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 801-817, August.
    10. Di Matteo, Livio, 2014. "Physician numbers as a driver of provincial government health spending in Canadian health policy," Health Policy, Elsevier, vol. 115(1), pages 18-35.
    11. Eibich, Peter & Ziebarth, Nicolas R., 2014. "Analyzing regional variation in health care utilization using (rich) household microdata," Health Policy, Elsevier, vol. 114(1), pages 41-53.
    12. 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.
    13. Elek, P. & Varadi, B. & Varga, M., 2014. "Effects of geographical accessibility on the use of outpatient care services: quasi-experimental evidence from administrative panel data," Health, Econometrics and Data Group (HEDG) Working Papers 14/17, HEDG, c/o Department of Economics, University of York.
    14. Anikó Bíró & Péter Elek, 2018. "How does retirement affect healthcare expenditures? Evidence from a change in the retirement age," Health Economics, John Wiley & Sons, Ltd., vol. 27(5), pages 803-818, May.
    15. Louise Devillers & Jonathan Sicsic & Angelique Delbarre & Josselin Le Bel & Emilie Ferrat & Olivier Saint Lary, 2018. "General Practitioner trainers prescribe fewer antibiotics in primary care: Evidence from France," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-12, January.
    16. Lily O’Hara & Jane Taylor, 2018. "What’s Wrong With the ‘War on Obesity?’ A Narrative Review of the Weight-Centered Health Paradigm and Development of the 3C Framework to Build Critical Competency for a Paradigm Shift," SAGE Open, , vol. 8(2), pages 21582440187, May.
    17. Massimo Filippini & Giuliano Masiero & Karine Moschetti, 2006. "Small area variations and welfare loss in the use of antibiotics in the community," Working Papers 0609, Department of Management, Information and Production Engineering, University of Bergamo.
    18. Bíró, Anikó & Prinz, Dániel, 2020. "Healthcare spending inequality: Evidence from Hungarian administrative data," Health Policy, Elsevier, vol. 124(3), pages 282-290.
    19. Astell-Burt, Thomas & Flowerdew, Robin & Boyle, Paul J. & Dillon, John F., 2011. "Does geographic access to primary healthcare influence the detection of hepatitis C?," Social Science & Medicine, Elsevier, vol. 72(9), pages 1472-1481, May.
    20. Lin, Yen-Ju & Tian, Wei-Hua & Chen, Chun-Chih, 2011. "Urbanization and the utilization of outpatient services under National Health Insurance in Taiwan," Health Policy, Elsevier, vol. 103(2), pages 236-243.

    More about this item

    Keywords

    Administrative panel data; Antibiotics; Primary care availability; Quality of antibiotic prescription; Unfilled general practices;
    All these keywords.

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:has:discpr:1810. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Nora Horvath (email available below). General contact details of provider: https://edirc.repec.org/data/iehashu.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.