Antibiotic Resistance: Socio-Economic Determinants and the Role of Information and Salience in Treatment Choice
Antibiotics have contributed to a tremendous increase in human well-being, saving many millions of lives. However, antibiotics become obsolete the more they are used as selection pressure promotes the development of resistant bacteria. The World Health Organization has proclaimed antibiotic resistance as a major global threat to public health. Today, 700,000 deaths per year are due to untreatable infections. To win the battle against antibiotic resistance, new policies affecting the supply and demand of existing and new drugs must be designed. In this project, we pursue new research to identify and evaluate feasible and effective demand-side policy interventions targeting the relevant decision makers: physicians and patients. ABRSEIST makes use of a broad econometric toolset to identify mechanisms linking antibiotic resistance and consumption exploiting a unique combination of physician-patient-level antibiotic resistance, treatment, and socio-economic data. Further, it aims to shed light on general practitioners’ acquisition and use of information under uncertainty about resistance in prescription choice, allowing counterfactual analysis of information-improving policies such as the provision of machine learning predictions in clinical practice and mandatory diagnostic testing. Using machine learning methods, theory-driven structural econometric analysis, and randomization in the field we work to provide rigorous evidence on effective intervention designs. This research will improve our understanding of how prescribing, resistance, and the effect of antibiotic use on resistance, are distributed in the general population which has important implications for the design of targeted interventions.
Research Output
- Machine predictions and human decisions with variation in payoffs and skill: the case of antibiotic prescribing (Michael Ribers and Hannes Ullrich)
- Machine learning and physician prescribing: a path to reduced antibiotic use (Michael Ribers and Hannes Ullrich)
- Provider effects in antibiotic prescribing: evidence from physician exits (Shan Huang and Hannes Ullrich)
- Assessing the value of data for prediction policies: The case of antibiotic prescribing (Shan Huang, Michael Ribers, and Hannes Ullrich)
- Selection bias in routine surveillance of antibiotic resistance (Michael Ribers)
- Competitive pressure and antibiotic prescribing in primary care (Temulun Borjigen and Hannes Ullrich)
Members
Temulun Borjigen
PhD Student, Berlin School of Economics, Department Firms and Markets, DIW Berlin
Research Assistant, Department of Economics, University of Copenhagen
Shan Huang
Postdoc, Department of Economics, University of Copenhagen
Postdoc, Department of Economics, Stockholm School of Economics
Rune Munck Aabenhus
Associate Professor of General Practice, Department of Public Health, University of Copenhagen
Michael Allan Ribers
Assistant Professor, Department of Economics, University of Copenhagen
Hannes Ullrich (Principal Investigator)
Research Associate, Department Firms and Markets, DIW Berlin
Associate Professor, Department of Economics, University of Copenhagen
Collaborators
Lars Bjerrum
Professor of General Practice, Department of Public Health, University of Copenhagen
Jonas Bredtoft Boel
Department of Clinical Microbiology, Copenhagen University Hospital—Herlev and Gentofte
Barbara Juliane Holzknecht
Senior Physician, Department of Clinical Microbiology, Copenhagen University Hospital—Herlev and Gentofte
Clinical Associate Professor, Department of Clinical Medicine, University of Copenhagen
Jette Brommann Kornum
Senior Physician, Department of Clinical Microbiology, Aalborg University Hospital
Michael Pedersen
Senior Physician, Department of Clinical Microbiology, Copenhagen University Hospital—Amager and Hvidovre
Janus Laust Thomsen
Professor of General Practice, Department of Clinical Medicine, Aalborg University
Director, Center for General Practice, Aalborg University
Former members
Gloria Cristina Cordoba Currea
Assistant Professor of General Practice, Department of Public Health, University of Copenhagen
Jonas Lieber
PhD Student, Department of Economics, University of Chicago
Research Assistant, Department of Economics, University of Copenhagen
Funding
This project is funded by the European Research Council under the European Union’s Horizon 2020 research and innovation programme (grant agreement no. 802450) for the period of 2019 – 2024.
