Primary Care Quality and Inappropriate Community Antibiotic Use: Evidence from Linked Provider and Household Data

Higher village doctor clinical practice quality in rural China is linked to lower inappropriate antibiotic receipt for cold or diarrhea symptoms, with DML-IV estimates of 9.6 percentage points.

• Why it matters: In resource-limited settings, antibiotics are widely accessible while quality primary care is constrained, leaving inappropriate community use as a major global health challenge.
• What they did: Using linked data from about 100 rural villages in China, the study combined unannounced standardized patient assessments of clinical practice quality with household antibiotic storage and use measures, applying an IV approach within a double/debiased machine learning framework.
• The result: Better clinical practice quality is also linked to fewer households storing antibiotics for future use (DML-IV: 10.9 percentage points), supporting community antibiotic stewardship via improved frontline care.

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