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患者知识与抗生素滥用:来自中国审计研究的证据。

Patient knowledge and antibiotic abuse: Evidence from an audit study in China.

机构信息

Department of Economics and Woodrow Wilson School, 316 Wallace Hall, Princeton University, Princeton NJ 08544, USA.

出版信息

J Health Econ. 2011 Sep;30(5):933-49. doi: 10.1016/j.jhealeco.2011.05.009. Epub 2011 Jun 16.

Abstract

We conduct an audit study in which a pair of simulated patients with identical flu-like complaints visits the same physician. Simulated patient A is instructed to ask a question that showcases his/her knowledge of appropriate antibiotic use, whereas patient B is instructed to say nothing beyond describing his/her symptoms. We find that a patient who displays knowledge of appropriate antibiotics use reduces both antibiotic prescription rates and drug expenditures. Such knowledge also increases physicians' information provision about possible side effects, but has a negative impact on the quality of the physician-patient interactions. Our results suggest that antibiotics abuse in China is not driven by patients actively demanding antibiotics, but is largely a supply-side phenomenon.

摘要

我们进行了一项审计研究,其中一对具有相同流感样症状的模拟患者拜访同一位医生。模拟患者 A 被指示提出一个问题,展示他/她对适当使用抗生素的了解,而模拟患者 B 除了描述他/她的症状外,什么也不说。我们发现,展示适当使用抗生素知识的患者会降低抗生素处方率和药物支出。这种知识也会增加医生提供有关可能副作用的信息,但会对医患互动的质量产生负面影响。我们的研究结果表明,中国的抗生素滥用不是由患者主动要求使用抗生素驱动的,而是主要是供应方现象。

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