(), Jens Dietrichson
() and Lina Maria Ellegård
Anders Anell: Department of Business Administration, Lund University
Jens Dietrichson: SFI - The Danish National Centre for Social Research
Lina Maria Ellegård: Department of Economics, Lund University, Postal: Department of Economics, School of Economics and Management, Lund University, Box 7082, S-220 07 Lund, Sweden
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.
42 pages, First version: December 15, 2015. Revised: June 29, 2016.
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