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Digital Waste? Unintended Consequences of Health Information Technology

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  • Böckerman, Petri
  • Kortelainen, Mika
  • Laine, Liisa T.
  • Nurminen, Mikko
  • Saxell, Tanja

Abstract

We exploit a large-scale natural experiment - the rollout of a nationwide electronic prescribing system in Finland - to study how digitization of prescriptions affects pharmaceutical use and health outcomes. We use comprehensive administrative data from patients treated with benzodiazepines, which are globally popular, effective but addictive psychotropic medications. We find no impact on benzodiazepine use on average, but among younger patients e-prescribing increases repeat prescription use. Younger patients' health outcomes do not improve but adverse outcomes, such as prescription drug abuse disorders and suicide attempts, increase dramatically. Improving access to medication through easier ordering may thus increase medication overuse.

Suggested Citation

  • Böckerman, Petri & Kortelainen, Mika & Laine, Liisa T. & Nurminen, Mikko & Saxell, Tanja, 2019. "Digital Waste? Unintended Consequences of Health Information Technology," Working Papers 117, VATT Institute for Economic Research.
    • Handle: RePEc:fer:wpaper:117
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    1. Amitabh Chandra & Jonathan Skinner, 2012. "Technology Growth and Expenditure Growth in Health Care," Journal of Economic Literature, American Economic Association, vol. 50(3), pages 645-680, September.
    2. Abby Alpert & David Powell & Rosalie Liccardo Pacula, 2018. "Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids," American Economic Journal: Economic Policy, American Economic Association, vol. 10(4), pages 1-35, November.
    3. Jinhyung Lee & Jeffrey S. McCullough & Robert J. Town, 2013. "The impact of health information technology on hospital productivity," RAND Journal of Economics, RAND Corporation, vol. 44(3), pages 545-568, September.
    4. Jessica Cohen & Pascaline Dupas & Simone Schaner, 2015. "Price Subsidies, Diagnostic Tests, and Targeting of Malaria Treatment: Evidence from a Randomized Controlled Trial," American Economic Review, American Economic Association, vol. 105(2), pages 609-645, February.
    5. Anja Sautmann & Samuel Brown & Mark Dean, 2016. "Subsidies, Information, and the Timing of Childrenís Health Care in Mali," Working Papers 2016-2, Brown University, Department of Economics.
    6. David Dranove & Chris Forman & Avi Goldfarb & Shane Greenstein, 2014. "The Trillion Dollar Conundrum: Complementarities and Health Information Technology," American Economic Journal: Economic Policy, American Economic Association, vol. 6(4), pages 239-270, November.
    7. Manudeep Bhuller & Magne Mogstad & Kjell G. Salvanes, 2017. "Life-Cycle Earnings, Education Premiums, and Internal Rates of Return," Journal of Labor Economics, University of Chicago Press, vol. 35(4), pages 993-1030.
    8. Amy Finkelstein & Matthew J Notowidigdo, 2019. "Take-Up and Targeting: Experimental Evidence from SNAP," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(3), pages 1505-1556.
    9. Jeffrey S. McCullough & Stephen T. Parente & Robert Town, 2016. "Health information technology and patient outcomes: the role of information and labor coordination," RAND Journal of Economics, RAND Corporation, vol. 47(1), pages 207-236, February.
    10. Bachhuber, M.A. & Hennessy, S. & Cunningham, C.O. & Starrels, J.L., 2016. "Increasing benzodiazepine prescriptions and overdose mortality in the United States, 1996-2013," American Journal of Public Health, American Public Health Association, vol. 106(4), pages 686-688.
    11. repec:mpr:mprres:7725 is not listed on IDEAS
    12. Amitabh Chandra & Douglas Staiger, 2016. "Sources of Inefficiency in Healthcare and Education," American Economic Review, American Economic Association, vol. 106(5), pages 383-387, May.
    13. repec:mpr:mprres:5411 is not listed on IDEAS
    14. Agha, Leila, 2014. "The effects of health information technology on the costs and quality of medical care," Journal of Health Economics, Elsevier, vol. 34(C), pages 19-30.
    15. Amalia R. Miller & Catherine E. Tucker, 2011. "Can Health Care Information Technology Save Babies?," Journal of Political Economy, University of Chicago Press, vol. 119(2), pages 289-324.
    16. Jason Abaluck & Leila Agha & Chris Kabrhel & Ali Raja & Arjun Venkatesh, 2016. "The Determinants of Productivity in Medical Testing: Intensity and Allocation of Care," American Economic Review, American Economic Association, vol. 106(12), pages 3730-3764, December.
    17. Anca M. Grecu & Dhaval M. Dave & Henry Saffer, 2019. "Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(1), pages 181-209, January.
    18. Barton H. Hamilton & Emily Jungheim & Brian McManus & Juan Pantano, 2018. "Health Care Access, Costs, and Treatment Dynamics: Evidence from In Vitro Fertilization," American Economic Review, American Economic Association, vol. 108(12), pages 3725-3777, December.
    19. Thomas C. Buchmueller & Colleen Carey, 2018. "The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 77-112, February.
    20. Carolina Lopez & Anja Sautmann & Simone Schaner, 2018. "The Contribution of Patients and Providers to the Overuse of Prescription Drugs," NBER Working Papers 25284, National Bureau of Economic Research, Inc.
    21. Cunningham, Colleen M. & Hanley, Gillian E. & Morgan, Steve, 2010. "Patterns in the use of benzodiazepines in British Columbia: Examining the impact of increasing research and guideline cautions against long-term use," Health Policy, Elsevier, vol. 97(2-3), pages 122-129, October.
    22. Jishnu Das & Alaka Holla & Aakash Mohpal & Karthik Muralidharan, 2016. "Quality and Accountability in Health Care Delivery: Audit-Study Evidence from Primary Care in India," American Economic Review, American Economic Association, vol. 106(12), pages 3765-3799, December.
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    1. Böckerman, Petri & Laine, Liisa & Nurminen, Mikko & Saxell, Tanja, 2020. "Information Integration, Coordination Failures, and Quality of Prescribing," IZA Discussion Papers 13926, Institute of Labor Economics (IZA).
    2. Abouk, Rahi & Powell, David, 2021. "Can electronic prescribing mandates reduce opioid-related overdoses?," Economics & Human Biology, Elsevier, vol. 42(C).
    3. Ahomäki, Iiro & Pitkänen, Visa & Soppi, Aarni & Saastamoinen, Leena, 2020. "Impact of a physician-targeted letter on opioid prescribing," Journal of Health Economics, Elsevier, vol. 72(C).

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    More about this item

    Keywords

    health information technology; electronic prescribing; repeat prescriptions; inefficiency; medication overuse; Local public finance and provision of public services; H51; H75; I12; I18; Terveyspalvelut;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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