Atella Vincenzo, Belotti Federico, Depalo Domenico
Department of Economics and Finance, University of Rome Tor Vergata, Rome, Italy.
CHP-PCOR, Stanford University, Stanford, CA, USA.
Health Econ. 2017 Sep;26 Suppl 2:106-126. doi: 10.1002/hec.3570.
Understanding the role that drug adherence has on health outcomes in everyday clinical practice is central for the policy maker. This is particularly true when patients suffer from asymptomatic chronic conditions (e.g., hypertension, hypercholesterolaemia, and diabetes). By exploiting a unique longitudinal dataset at patient and physician level in Italy, we show that patients and physicians unobserved characteristics play an important role in determining health status, at least as important as drug adherence. Most importantly, we find that both adherence and prescribed treatment regimen effects are highly heterogeneous across physicians, highlighting their crucial role in shaping patients' health status.
了解药物依从性在日常临床实践中对健康结果的作用，对政策制定者来说至关重要。当患者患有无症状慢性病（如高血压、高胆固醇血症和糖尿病）时，情况尤其如此。通过利用意大利患者和医生层面的独特纵向数据集，我们表明，患者和医生未被观察到的特征在决定健康状况方面发挥着重要作用，至少与药物依从性一样重要。最重要的是，我们发现依从性和规定治疗方案的效果在不同医生之间存在高度异质性，突出了他们在塑造患者健康状况方面的关键作用。
