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Can Pay-for-Performance to Primary Care Providers Stimulate Appropriate Use of Antibiotics?

Author

Listed:
  • Anell, Anders

    (Department of Business Administration, Lund University)

  • Dietrichson, Jens

    (SFI - The Danish National Centre for Social Research)

  • Ellegård, Lina Maria

    (Department of Economics, Lund University)

Abstract

Antibiotics resistance is a major threat to public health. We examine if pay-for-performance (P4P) to primary care providers stimulates appropriate prescription of antibiotics; specifically, if P4P induces a substitution of narrow-spectrum antibiotics for broad-spectrum antibiotics (which contribute more to resistance) in the treatment of children with respiratory tract infections (RTI). During 2006-2013, a subset of Swedish healthcare authorities introduced antibiotics-related P4P in their reimbursement schemes for care providers. We employ municipality-level data covering all purchases of RTI antibiotics in a difference-in-differences analysis, and find that P4P significantly increased the share of narrow-spectrum antibiotics. There were no signs that physicians tried to game the system by increasing overall antibiotics use.

Suggested Citation

  • Anell, Anders & Dietrichson, Jens & Ellegård, Lina Maria, 2015. "Can Pay-for-Performance to Primary Care Providers Stimulate Appropriate Use of Antibiotics?," Working Papers 2015:36, Lund University, Department of Economics, revised 29 Jun 2016.
    • Handle: RePEc:hhs:lunewp:2015_036
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Paul Mitchell’s journal round-up for 17th July 2017
      by paulmitchell1 in The Academic Health Economists' Blog on 2017-07-17 16:00:07

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    Cited by:

    1. Ramerman, Lotte & Hek, Karin & Cramer- van der Welle, Christine & Simons-Winters, Ellis & Middelweerd, Anouk & Lambooij, Anke & Verheij, Robert, 2022. "Incentivizing appropriate prescribing in primary care: Development and first results of an electronic health record-based pay-for-performance scheme," Health Policy, Elsevier, vol. 126(10), pages 1010-1017.
    2. Granlund, David & Zykova, Yana, 2020. "Can privatisation of primary care contribute to the spread of antibiotic resistance?," Umeå Economic Studies 977, Umeå University, Department of Economics.
    3. Anell, Anders, 2019. "Performance management and audit & feedback to support learning and innovation – Theoretical review and implications for Swedish primary care," Papers in Innovation Studies 2019/11, Lund University, CIRCLE - Centre for Innovation Research.
    4. Anell, Anders & Dietrichson, Jens & Ellegård, Lina Maria & Kjellsson, Gustav, 2021. "Information, switching costs, and consumer choice: Evidence from two randomised field experiments in Swedish primary health care," Journal of Public Economics, Elsevier, vol. 196(C).
    5. Lina Maria Ellegård, 2020. "Effects of pay-for-performance on prescription of hypertension drugs among public and private primary care providers in Sweden," International Journal of Health Economics and Management, Springer, vol. 20(3), pages 215-228, September.
    6. Shan Huang & Hannes Ullrich, 2021. "Physician Effects in Antibiotic Prescribing: Evidence from Physician Exits," Discussion Papers of DIW Berlin 1958, DIW Berlin, German Institute for Economic Research.
    7. Anell, Anders & Dackehag, Margareta & Dietrichson, Jens & Ellegård, Lina Maria & Kjellsson, Gustav, 2022. "Better Off by Risk Adjustment? Socioeconomic Disparities in Care Utilization in Sweden Following a Payment Reform," Working Papers 2022:15, Lund University, Department of Economics, revised 12 Mar 2024.
    8. Blix, Mårten & Jeansson, Johanna, 2018. "Telemedicine and the Welfare State: The Swedish Experience," Working Paper Series 1238, Research Institute of Industrial Economics.
    9. Shan Huang & Hannes Ullrich, 2023. "Provider effects in antibiotic prescribing: Evidence from physician exits," Berlin School of Economics Discussion Papers 0018, Berlin School of Economics.

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    More about this item

    Keywords

    pay-for-performance; antibiotics resistance; primary care;
    All these keywords.

    JEL classification:

    • D23 - Microeconomics - - Production and Organizations - - - Organizational Behavior; Transaction Costs; Property Rights
    • H73 - Public Economics - - State and Local Government; Intergovernmental Relations - - - Interjurisdictional Differentials and Their Effects
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J33 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Compensation Packages; Payment Methods
    • J38 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Public Policy

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