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

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


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.

MeSH terms

  • Adult
  • Anti-Bacterial Agents*
  • China
  • Drug Utilization Review*
  • Empirical Research
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Influenza, Human / drug therapy
  • Male
  • Medical Audit
  • Middle Aged
  • Patient Simulation
  • Physician-Patient Relations*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Young Adult


  • Anti-Bacterial Agents