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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," KRTK-KTI WORKING PAPERS 1810, Institute of Economics, Centre for Economic and Regional Studies.
    • Handle: RePEc:has:discpr:1810
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    References listed on IDEAS

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    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.
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    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

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