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Effects of Competition between Healthcare Providers on Prescription of Antibiotics

Author

Listed:
  • Fogelberg, Sara

    (Research Institute of Industrial Economics (IFN))

Abstract

The introduction of antibiotics as a medical treatment after World War II helped to dramatically increase life expectancy in the industrialized world. However, over-prescription of antibiotics during the last few decades has led to a sharp increase in multi-resistant bacteria, disarming once powerful anti-pathogens. This paper investigates the effects of increased competition between healthcare providers on prescription of antibiotics. The analysis makes use of a competition-inducing reform implemented in different counties in Sweden at different points in time between 2007 and 2010 for a difference-in-differences approach. Since the dataset contains monthly data on all prescribed antibiotics in Sweden it is possible to estimate the effects on all antibiotics prescribed, as well as on different subcategories of antibiotics. The results show that increased competition had a positive and significant effect on prescription of antibiotics. This increase in prescription of antibiotics was not associated with a reduction in sick leave.

Suggested Citation

  • Fogelberg, Sara, 2013. "Effects of Competition between Healthcare Providers on Prescription of Antibiotics," Working Paper Series 949, Research Institute of Industrial Economics, revised 20 Nov 2014.
    • Handle: RePEc:hhs:iuiwop:0949
    as

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    References listed on IDEAS

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    1. Brekke, Kurt R. & Nuscheler, Robert & Straume, Odd Rune, 2007. "Gatekeeping in health care," Journal of Health Economics, Elsevier, vol. 26(1), pages 149-170, January.
    2. Zack Cooper & Stephen Gibbons & Simon Jones & Alistair McGuire, 2011. "Does Hospital Competition Save Lives? Evidence From The English NHS Patient Choice Reforms," Economic Journal, Royal Economic Society, vol. 121(554), pages 228-260, August.
    3. David Card, 1992. "Using Regional Variation in Wages to Measure the Effects of the Federal Minimum Wage," ILR Review, Cornell University, ILR School, vol. 46(1), pages 22-37, October.
    4. Daniel P. Kessler & Mark B. McClellan, 2000. "Is Hospital Competition Socially Wasteful?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(2), pages 577-615.
    5. Gravelle, Hugh & Masiero, Giuliano, 2000. "Quality incentives in a regulated market with imperfect information and switching costs: capitation in general practice," Journal of Health Economics, Elsevier, vol. 19(6), pages 1067-1088, November.
    6. David Card, 1992. "Using Regional Variation in Wages to Measure the Effects of the Federal Minimum Wage," Working Papers 680, Princeton University, Department of Economics, Industrial Relations Section..
    7. Martin Gaynor & Rodrigo Moreno-Serra & Carol Propper, 2013. "Death by Market Power: Reform, Competition, and Patient Outcomes in the National Health Service," American Economic Journal: Economic Policy, American Economic Association, vol. 5(4), pages 134-166, November.
    8. Carol Propper & Simon Burgess & Denise Gossage, 2008. "Competition and Quality: Evidence from the NHS Internal Market 1991–9," Economic Journal, Royal Economic Society, vol. 118(525), pages 138-170, January.
    9. Robert Nuscheler, 2003. "Physician Reimbursement, Time-Consistency and the Quality of Care," Journal of Institutional and Theoretical Economics (JITE), Mohr Siebeck, Tübingen, vol. 159(2), pages 302-322, June.
    10. 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.
    11. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    12. repec:fth:prinin:300 is not listed on IDEAS
    13. Ian Greener & Russell Mannion, 2009. "Patient choice in the NHS: what is the effect of choice policies on patients and relationships in health economies?," Public Money & Management, Taylor & Francis Journals, vol. 29(2), pages 95-100, March.
    14. Beitia, Arantza, 2003. "Hospital quality choice and market structure in a regulated duopoly," Journal of Health Economics, Elsevier, vol. 22(6), pages 1011-1036, November.
    15. Karlsson, Martin, 2007. "Quality incentives for GPs in a regulated market," Journal of Health Economics, Elsevier, vol. 26(4), pages 699-720, July.
    16. Gravelle, Hugh, 1999. "Capitation contracts: access and quality," Journal of Health Economics, Elsevier, vol. 18(3), pages 315-340, June.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. #HEJC for 01/04/2013 (new time!)
      by Chris Sampson in The Academic Health Economists' Blog on 2013-03-25 13:00:43

    Citations

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    Cited by:

    1. Lina Maria Ellegård & Jens Dietrichson & Anders Anell, 2018. "Can pay‐for‐performance to primary care providers stimulate appropriate use of antibiotics?," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 39-54, January.
    2. Sebastian Panthöfer, 2022. "Do doctors prescribe antibiotics out of fear of malpractice?," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 19(2), pages 340-381, June.
    3. 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).
    4. Jens Dietrichson & Lina Maria Ellegård & Gustav Kjellsson, 2020. "Patient choice, entry, and the quality of primary care: Evidence from Swedish reforms," Health Economics, John Wiley & Sons, Ltd., vol. 29(6), pages 716-730, June.
    5. 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.

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    More about this item

    Keywords

    Healthcare; Competition; Competition reform; Antibiotics;
    All these keywords.

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • H30 - Public Economics - - Fiscal Policies and Behavior of Economic Agents - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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