Working Paper: NBER ID: w18153
Authors: Janet Currie; Wanchuan Lin; Juanjuan Meng
Abstract: The overuse of medical services including antibiotics is often blamed on Physician Induced Demand. But since this theory is about physician motivations, it is difficult to test. We conduct an audit study in which physician financial incentives, beliefs about what patients want, and desires to reciprocate for a small gift are systematically varied. We find that all of these treatments reduce antibiotics prescriptions, suggesting that antibiotics abuse in China is not driven by patients actively demanding antibiotics, by physicians believing that patients want antibiotics, or by physicians believing that antibiotics are in the best interests of their patients, but is largely driven by financial incentives. Our results also show that physician behavior can be significantly influenced by the receipt of a token gift, such as a pen.
Keywords: antibiotic abuse; physician induced demand; audit study; China
JEL Codes: I11
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Financial incentives (M52) | Higher antibiotic prescription rates (I11) |
| Removal of financial incentives (G28) | Lower antibiotic prescription rates (I11) |
| Small gift (pen) (D64) | Lower antibiotic prescription rates (I11) |
| Removal of financial incentives (G28) | Lower likelihood of prescribing more expensive grade 2 antibiotics (D40) |