Antibiotic prescription: Knowledge among physicians and nurses in western Sweden.

Misuse and overuse of antibiotics are common in primary care. Guidelines for prescribing of antibiotics are often not followed We conducted a survey of 120 health centers in western Sweden to investigate to what extent physicians and nurses think they know and comply with the guidelines for prescribing of antibiotics. A large majority of the respondents answered that they know the guidelines well. However, many also believed that physicians/nurses in general know less about and are worse at following the guidelines than themselves, indicating optimism bias. According to the respondents the main reason for non-compliance with guidelines was patient expectations. The survey also showed that both physicians' and nurses' actual knowledge of when it is effective to prescribe antibiotics is incomplete. Interventions to reduce unnecessary antibiotic therapy in primary care should target the failing congruence between the perceived knowledge of guidelines for antibiotic therapy and actual knowledge.

Are only-children different? Evidence from a lab-in-the-field experiment of the Chinese one-child policy.

In this paper, we present evidence from a lab-in-the-field experiment of the effects of the Chinese one-child policy on adults in China who were born just before and after the introduction of the policy. We measure risk, uncertainty, and time preferences, as well as subjects' preferences in the social domain, i.e., concerning competitiveness, cooperation, and bargaining. We sampled people from three Chinese provinces born both before and after the introduction of the policy in 1979. We utilize the fact that the one-child policy was introduced at different times and with different degrees of strictness in different provinces. Overall, we find a statistically significant effect only on risk and uncertainty aversion and not on any other preferences in the experiments: Those born after the introduction of the one-child policy are less risk and uncertainty averse. These results hold for various robustness checks and heterogeneity tests. Hence, our results do not confirm the general wisdom and stereotype of only-children in China being "little emperors."

Name matters! The cost of having a foreign-sounding name in the Swedish private housing market.

Both immigration and a troubling housing deficit have increased rapidly in Sweden over the past 20 years. In this internet-based field experiment, we investigated whether there exists discrimination in the Swedish private rental housing market based on the names of apartment seekers. We used a correspondent test by randomly submitting equivalent applications from four fictitious, highly educated, and seemingly "well-behaved" male applicants in response to a number of randomly selected private housing ads. Each advertising landlord received applications from two applicants with names signaling Swedish, Arab/Muslim, Eastern European, or East Asian ethnicity. Our results show that the person with a name associated with the dominant ethnic group received most callbacks from the landlords, while the persons with Eastern European- and East Asian sounding names, and especially the Arab/Muslim-sounding name, yielded significantly lower callback rates. Moreover, each applicant's callback rates are about the same regardless of whom he was paired with, reinforcing our result that a person's name clearly matters when applying for an apartment. The comparisons with previous discrimination research focusing on the Swedish housing market show that the situation for a male person with an Arabic/Muslim-sounding name has at least not improved in Sweden in the past decade.

Interventions for prudent antibiotic use in primary healthcare: an econometric analysis.

BACKGROUND: Rational antibiotic prescribing is crucial to combat antibiotic resistance. Optimal strategies to improve antibiotic use are not known. Strama, the Swedish strategic program against antibiotic resistance, has been successful in reducing antibiotic prescription rates. This study investigates whether two specific interventions directed toward healthcare centers, an informational visit and a self-evaluation meeting, played a role in observed reduction in rates of antibiotic prescriptions in primary healthcare. METHODS: The study was a retrospective, observational, empirical analysis exploiting the variation in the timing of the interventions and considering past prescriptions through use of estimations from dynamic panel data models. Primary healthcare data from 2011 to 2014 were examined. Data were from public and private primary healthcare centers in western Sweden. The key variables were prescription of antibiotics and indicator variables for the two interventions. RESULTS: The first intervention, an educational information intervention, decreased the number of prescriptions among public healthcare centers, but this effect was only temporary. We found no proof that the second intervention, a self-evaluation meeting at the healthcare center, had an impact on the reduction of prescriptions. CONCLUSIONS: Single educational interventions aimed at influencing rates of antibiotic prescriptions have limited impact. A multifaceted approach is needed in efforts to reduce the use of antibiotics in primary health care.

Who is willing to stay sick for the collective? - Individual characteristics, experience, and trust.

•We study attitudes towards antibiotics and antibiotic resistance.•We analyze results from a novel web-survey of Swedish citizens (n = 1906).•Acceptability of doctor's decision not to prescribe antibiotics was found to be large.•Trust in the healthcare sector is linked to acceptability of doctor's decision.•Concern about antibiotic resistance is linked to willingness to limit antibiotic use.