The Question

Does physician competition drive up antibiotic prescribing? How does the existence of urgent care and retail clinics affect antibiotic prescription rates across different socioeconomic strata?

What we found

Our study found that physician offices per capita are an important driver for prescription rates—overall there was a clear correlation between an increase in physician density and prescriptions. This varied based on socioeconomic conditions, however. In poorer areas, clinics substitute for traditional physician offices, reducing the impact of physician density. In wealthier areas, clinics increase the effect of physician density on the prescribing rate.

Why it matters

The relationship between healthcare access, competition for patients, and antibiotic prescriptions have significant policy implications. Knowing what drives prescription rates can help predict changes in antibiotic consumption based on socioeconomic and demographic data, and help target information campaigns focused on combating antibiotic resistance and appropriate prescribing. Understanding the role of urgent care centers and retail clinics in these consumption patterns is a key component of both addressing issues of access (in poorer areas) and of potentially inappropriate prescribing (more likely in wealthier areas based on physician competition).