Title of the publicationCan pay-for-performance to primary care providers stimulate appropriate use of antibiotics?
Abstract

Summary
Antibiotic resistance is a major threat to public health worldwide. As the healthcare
sector's use of antibiotics is an important contributor to the development of
resistance, it is crucial that physicians only prescribe antibiotics when needed and
that they choose narrow-spectrum antibiotics, which act on fewer bacteria types,
when possible. Inappropriate use of antibiotics is nonetheless widespread, not least
for respiratory tract infections (RTI), a common reason for antibiotics prescriptions.
We examine if pay-for-performance (P4P) presents a way to influence primary care
physicians' choice of antibiotics. During 2006–2013, 8 Swedish healthcare authorities
adopted P4P to make physicians select narrow-spectrum antibiotics more often
in the treatment of children with RTI. Exploiting register data on all purchases
of RTI antibiotics in a difference-in-differences analysis, we find that P4P significantly
increased the share of narrow-spectrum antibiotics. There are no signs that
physicians gamed the system by issuing more prescriptions overall.
KEYWORDS
antibiotic resistance, pay-for-performance, primary care

DOIhttps://doi.org/10.1002/hec.3535
Name of the first authorEllegård, Lina Maria
Year of publication2017
Study design of the publicationOther study design
If other study design, please specifydifference-in-differences analysis
Method for data collection and analysis
  • Quantitative data - Quantitative data were used during the intervention
Quantitative data - Quantitative data were used during the intervention
Sector
  • Human - All activities regarding organisations and individuals involved in health products and services
Sub-sectorSub-sectors are further units of demarcation within a sector E.g. awareness campaign from veterinarians to cat owners about toxoplasmosis drug resistance and transmission of resistant bacteria: ANIMAL, PETS
Subsector (human)
  • Healthcare delivery
Healthcare delivery