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抗生素处方中的医疗服务提供者效应

Provider Effects in Antibiotic Prescribing
Journal of Human Resources · 2024 · Shan Huang、Hannes Ullrich

中文摘要

在应对抗生素耐药性的过程中,既减少抗生素使用又维持医疗服务质量,构成一项至关重要的卫生政策挑战。我们利用患者与医生匹配的外生变异,考察诊疗风格对患者抗生素使用的影响。诊疗风格的异质性解释了初级保健服务提供者之间抗生素总体使用差异的49%,以及二线抗生素使用差异的83%。我们没有发现高处方量与更高的治疗质量或更少的不良健康结局相关的证据。改善医生决策的政策,尤其是针对高处方量医生的政策,可能有助于在维持医疗服务质量的同时减少抗生素使用。

Abstract

<h3>Abstract</h3> In the fight against antibiotic resistance, reducing antibiotic consumption while preserving healthcare quality presents a critical health policy challenge. We investigate the role of practice styles in patients’ antibiotic intake using exogenous variation in patient-physician assignment. Practice style heterogeneity explains 49% of the differences in overall antibiotic use and 83% of the differences in second-line antibiotic use between primary care providers. We find no evidence that high prescribing is linked to better treatment quality or fewer adverse health outcomes. Policies improving physician decision-making, particularly among high-prescribers, may be effective in reducing antibiotic consumption while sustaining healthcare quality.
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