Corruption and Antibiotic Use in the European Regions

Objective: To investigate the association between two measures of corruption – prevalence of corruption in the health sector and prevalence of bribes in the society – and antibiotic consumption in the European regions. Methods: Data on the dependent variable antibiotic consumption on the regional level comes from the 2009 Special Euro Barometer Survey. Measures of the two independent variables corruption in the health care sector and bribes in the society come from the European Quality of Government Index. Correlation coefficients were calculated to investigate the bivariate correlation between the independent variables health sector corruption and prevalence of bribes and the dependent variable antibiotic consumption. A multivariate regression model was built to investigate the association between corruption and bribes in relation to antibiotics, taking the potential confounders purchasing power standardized regional GDP, regional quality of health care, inhabitants per medical doctor, and age-standardized all case mortality rates into consideration. Results: Strong and significant bivariate correlations between both corruption in the health sector and prevalence of bribes in society and antibiotic consumption in the European regions were found. In a multivariate regression model including confounders, the associations were persistent and strong. Conclusions: This paper demonstrates that dysfunctional regulatory systems and poor enforcement mechanisms seem to be factors accounting for some of the between-region variation in antibiotic consumption in Europe